Single tablet HIV regimens facilitate virologic suppression and retention in care among treatment naïve patients*

Vagish S. Hemmige, Charlene A. Flash, Josephinel Carter, Thomas P. Giordano, Teddy Zerai

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Newer HIV regimens are typically taken once daily but vary in the number of pills required. Whether the number of pills in a once-daily HIV regimen affects clinical outcomes is unknown. We retrospectively compared adherence, retention in care, and virologic outcomes between patients starting a once daily single-tablet regimen (STR) to patients starting a once-daily multi-tablet regimen (MTR) in a publicly funded clinic in the United States. Outcomes were measured in the year after starting ART and included retention in care, virologic suppression, and medication possession ratio of at least 80%. Data from patients initiating therapy from 1 January 2008 to 31 December 2011 were analyzed with both unadjusted and propensity-score adjusted regression. Overall, 622 patients started with an STR (100% efavirenz-based) and 406 with an MTR (65% atazanavir-based and 35% darunavir-based) regimen. Retention in care was achieved in 80.7% of STR patients vs. 72.7% of MTR patients (unadjusted OR 1.57, 95% CI 1.17–2.11; adjusted OR 1.49, 95% CI 1.10–2.02). Virologic suppression occurred among 84.4% of STR patients vs. 77.6% of MTR patients (unadjusted OR 1.56; 95% CI 1.14–2.15; adjusted OR 1.41; 95% CI 1.02–1.96). There was no difference in the proportion of patients achieving at least 80% adherence, as measured by medication possession ratio (33.0% of STR patients and 30.1% of MTR patients; unadjusted OR 1.14; 95% CI 0.87–1.50; adjusted OR 1.04, CI 0.79–1.38). While it is difficult to eliminate confounding in this observational study, retention in care and virologic outcomes were better in patients prescribed STRs.

Original languageEnglish (US)
Pages (from-to)1017-1024
Number of pages8
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Volume30
Issue number8
DOIs
StatePublished - Aug 3 2018
Externally publishedYes

Fingerprint

suppression
Tablets
HIV
possession
medication
Therapeutics
efavirenz
regression
Propensity Score
Observational Studies

Keywords

  • Adherence
  • pill burden
  • retention in care

ASJC Scopus subject areas

  • Health(social science)
  • Social Psychology
  • Public Health, Environmental and Occupational Health

Cite this

Single tablet HIV regimens facilitate virologic suppression and retention in care among treatment naïve patients* . / Hemmige, Vagish S.; Flash, Charlene A.; Carter, Josephinel; Giordano, Thomas P.; Zerai, Teddy.

In: AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV, Vol. 30, No. 8, 03.08.2018, p. 1017-1024.

Research output: Contribution to journalArticle

@article{e7174d797b3044a78be2c6473cbaa994,
title = "Single tablet HIV regimens facilitate virologic suppression and retention in care among treatment na{\"i}ve patients*",
abstract = "Newer HIV regimens are typically taken once daily but vary in the number of pills required. Whether the number of pills in a once-daily HIV regimen affects clinical outcomes is unknown. We retrospectively compared adherence, retention in care, and virologic outcomes between patients starting a once daily single-tablet regimen (STR) to patients starting a once-daily multi-tablet regimen (MTR) in a publicly funded clinic in the United States. Outcomes were measured in the year after starting ART and included retention in care, virologic suppression, and medication possession ratio of at least 80{\%}. Data from patients initiating therapy from 1 January 2008 to 31 December 2011 were analyzed with both unadjusted and propensity-score adjusted regression. Overall, 622 patients started with an STR (100{\%} efavirenz-based) and 406 with an MTR (65{\%} atazanavir-based and 35{\%} darunavir-based) regimen. Retention in care was achieved in 80.7{\%} of STR patients vs. 72.7{\%} of MTR patients (unadjusted OR 1.57, 95{\%} CI 1.17–2.11; adjusted OR 1.49, 95{\%} CI 1.10–2.02). Virologic suppression occurred among 84.4{\%} of STR patients vs. 77.6{\%} of MTR patients (unadjusted OR 1.56; 95{\%} CI 1.14–2.15; adjusted OR 1.41; 95{\%} CI 1.02–1.96). There was no difference in the proportion of patients achieving at least 80{\%} adherence, as measured by medication possession ratio (33.0{\%} of STR patients and 30.1{\%} of MTR patients; unadjusted OR 1.14; 95{\%} CI 0.87–1.50; adjusted OR 1.04, CI 0.79–1.38). While it is difficult to eliminate confounding in this observational study, retention in care and virologic outcomes were better in patients prescribed STRs.",
keywords = "Adherence, pill burden, retention in care",
author = "Hemmige, {Vagish S.} and Flash, {Charlene A.} and Josephinel Carter and Giordano, {Thomas P.} and Teddy Zerai",
year = "2018",
month = "8",
day = "3",
doi = "10.1080/09540121.2018.1442554",
language = "English (US)",
volume = "30",
pages = "1017--1024",
journal = "AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV",
issn = "0954-0121",
publisher = "Routledge",
number = "8",

}

TY - JOUR

T1 - Single tablet HIV regimens facilitate virologic suppression and retention in care among treatment naïve patients*

AU - Hemmige, Vagish S.

AU - Flash, Charlene A.

AU - Carter, Josephinel

AU - Giordano, Thomas P.

AU - Zerai, Teddy

PY - 2018/8/3

Y1 - 2018/8/3

N2 - Newer HIV regimens are typically taken once daily but vary in the number of pills required. Whether the number of pills in a once-daily HIV regimen affects clinical outcomes is unknown. We retrospectively compared adherence, retention in care, and virologic outcomes between patients starting a once daily single-tablet regimen (STR) to patients starting a once-daily multi-tablet regimen (MTR) in a publicly funded clinic in the United States. Outcomes were measured in the year after starting ART and included retention in care, virologic suppression, and medication possession ratio of at least 80%. Data from patients initiating therapy from 1 January 2008 to 31 December 2011 were analyzed with both unadjusted and propensity-score adjusted regression. Overall, 622 patients started with an STR (100% efavirenz-based) and 406 with an MTR (65% atazanavir-based and 35% darunavir-based) regimen. Retention in care was achieved in 80.7% of STR patients vs. 72.7% of MTR patients (unadjusted OR 1.57, 95% CI 1.17–2.11; adjusted OR 1.49, 95% CI 1.10–2.02). Virologic suppression occurred among 84.4% of STR patients vs. 77.6% of MTR patients (unadjusted OR 1.56; 95% CI 1.14–2.15; adjusted OR 1.41; 95% CI 1.02–1.96). There was no difference in the proportion of patients achieving at least 80% adherence, as measured by medication possession ratio (33.0% of STR patients and 30.1% of MTR patients; unadjusted OR 1.14; 95% CI 0.87–1.50; adjusted OR 1.04, CI 0.79–1.38). While it is difficult to eliminate confounding in this observational study, retention in care and virologic outcomes were better in patients prescribed STRs.

AB - Newer HIV regimens are typically taken once daily but vary in the number of pills required. Whether the number of pills in a once-daily HIV regimen affects clinical outcomes is unknown. We retrospectively compared adherence, retention in care, and virologic outcomes between patients starting a once daily single-tablet regimen (STR) to patients starting a once-daily multi-tablet regimen (MTR) in a publicly funded clinic in the United States. Outcomes were measured in the year after starting ART and included retention in care, virologic suppression, and medication possession ratio of at least 80%. Data from patients initiating therapy from 1 January 2008 to 31 December 2011 were analyzed with both unadjusted and propensity-score adjusted regression. Overall, 622 patients started with an STR (100% efavirenz-based) and 406 with an MTR (65% atazanavir-based and 35% darunavir-based) regimen. Retention in care was achieved in 80.7% of STR patients vs. 72.7% of MTR patients (unadjusted OR 1.57, 95% CI 1.17–2.11; adjusted OR 1.49, 95% CI 1.10–2.02). Virologic suppression occurred among 84.4% of STR patients vs. 77.6% of MTR patients (unadjusted OR 1.56; 95% CI 1.14–2.15; adjusted OR 1.41; 95% CI 1.02–1.96). There was no difference in the proportion of patients achieving at least 80% adherence, as measured by medication possession ratio (33.0% of STR patients and 30.1% of MTR patients; unadjusted OR 1.14; 95% CI 0.87–1.50; adjusted OR 1.04, CI 0.79–1.38). While it is difficult to eliminate confounding in this observational study, retention in care and virologic outcomes were better in patients prescribed STRs.

KW - Adherence

KW - pill burden

KW - retention in care

UR - http://www.scopus.com/inward/record.url?scp=85042920034&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85042920034&partnerID=8YFLogxK

U2 - 10.1080/09540121.2018.1442554

DO - 10.1080/09540121.2018.1442554

M3 - Article

VL - 30

SP - 1017

EP - 1024

JO - AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV

JF - AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV

SN - 0954-0121

IS - 8

ER -