Abstract

BackgroundThe use of single-tablet regimens (STRs) in HIV treatment is ubiquitous. However, reintroducing the (generic) components as multi-tablet regimens (MTRs) could be an interesting cost-reducing strategy. It is essential to involve patient-reported outcome measures (PROs) to examine the effects of such an approach. Hence, this study compared PROs of people living with HIV taking an STR versus a MTR in a real world setting.Materials and methodsThis longitudinal study included 188 people living with HIV. 132 remained on a MTR and 56 switched to an STR. At baseline, months 1-3-6-12-18 and 24, participants filled in questionnaires on health-related quality of life (HRQoL), depressive symptoms, HIV symptoms, neurocognitive complaints (NCC), treatment satisfaction and adherence. Generalized linear mixed models and generalized estimation equations mixed models were built.ResultsClinical parameters and PROs of the two groups were comparable at baseline. Neurocognitive complaints and treatment satisfaction did differ over time among the groups. In the STR-group, the odds of having NCC increased monthly by 4,1% as compared to the MTR-group (p = 0.035). Moreover, people taking an STR were more satisfied with their treatment after 6 months: the median change score was high: 24 (IQR 7,5–29). Further, treatment satisfaction showed a contrary evolution in the groups: the estimated state score of the STR-group increased by 3,3 while it decreased by 0,2 in the MTR-group (p = 0.003). No differences over time between the groups were observed with regard to HRQoL, HIV symptoms, depressive symptoms and adherence.ConclusionsNeurocognitive complaints were more frequently reported among people on an STR versus MTR. This finding contrasts with the higher treatment satisfaction in the STR-group over time. The long-term effects of both PROs should guide the decision-making on STRs vs. (generic) MTRs.

Highlights

  • The past decades have been dominated by positive evolutions in the treatment of people living with HIV (PLHIV)

  • This study compared patient-reported outcome measures (PROs) of people living with HIV taking an single-tablet regimens (STRs) versus a multi-tablet regimen (MTR) in a real world setting

  • Treatment satisfaction showed a contrary evolution in the groups: the estimated state score of the STRgroup increased by 3,3 while it decreased by 0,2 in the MTR-group (p = 0.003)

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Summary

Introduction

The past decades have been dominated by positive evolutions in the treatment of people living with HIV (PLHIV). Clay et al compared 48 week outcomes between STRs and MTRs in a meta-analysis and found that viral suppression was more likely in the STRgroup [4]. A large French cohort study, not included in the meta-analysis of Clay et al, found no difference in virological efficacy between STRs and MTRs in HIV-naive patients [5]. Another recent Italian cohort study reported similar virological control among PLHIV starting an STR and those starting a 2-pills, once daily MTR [6]. This study compared PROs of people living with HIV taking an STR versus a MTR in a real world setting

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