How Does Pill Burden Impact HIV Outcomes?
A single-tablet regimen (STR) for HIV/AIDS patients correlates with greater adherence (p<0.0001) and a lower risk of hospitalization (p=0.0076), when compared to a multiple-tablet regimen (MTR). That's according to a new retrospective cohort study conducted by researchers at the University of South Carolina and published in the journal Pharmacotherapy.
The researchers evaluated 2,174 patients who were covered by Medicaid in South Carolina between January 1, 2006 and December 31, 2013. Five-hundred and eighty of those patients were dispensed a complete antiretroviral therapy STR, while 1,594 were dispensed a complete MTR. The STR and MTR cohorts were on average similar in terms of age at index date, Charlson Comorbidity Index score, sex, drug abuse, and mental health diagnoses. However, they differed significantly in racial composition, index year of regimen, previous treatment, baseline viral load, and CD4 measures.
Bivariate X2 and Wilcoxon rank sum tests, as well as multivariate regression models, were used to evaluate the differences in outcomes. The bivariate analysis showed that the STR cohort had better adherence, was associated with a lower risk of hospitalization, and had a higher proportion of patients with viral suppression (64.5% vs 49.5%, p<0.0001). Similar outcomes were seen with the multivariate regression models, except for viral load suppression, where no significant difference was seen between the STR and MTR cohorts.
Although viral suppression was seen in a higher proportion of patients in the STR cohort over the MTR cohort during the follow-up period, there was no significant difference witnessed in viral suppression when controlling for adherence.
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