Compliance with clinical guidelines and adherence to antiretroviral therapy among patients living with HIV

Tandon, Neeta; Mao, Jianbin; Shprecher, Adam; Anderson, Amy; Cao, Feng; Jiao, Xiaolong; Brown, Kimberley

doi:10.1080/03007995.2018.1519499

Cited by 13 publications

(11 citation statements)

References 34 publications

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“…Third, as the NRTI exposure prevalence was markedly different between HIV-positive and hepatitis B-positive persons (Supplementary Tables 17-21), we performed another sensitivity analysis by analyzing these populations separately. The proportions of HIV-positive patients who did not have a record of NRTI exposure (VA -34%; Truven -1%; PearlDiver -17%; Medicare -19%; Clinformatics -24%) were similar to previously reported rates 38,39 . Because this subgroup analysis markedly reduces the sample sizes, we again studied the largest Veterans cohort.…”

Section: Resultssupporting

confidence: 81%

Repurposing anti-inflammasome NRTIs for improving insulin sensitivity and reducing type 2 diabetes development

et al. 2020

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Innate immune signaling through the NLRP3 inflammasome is activated by multiple diabetes-related stressors, but whether targeting the inflammasome is beneficial for diabetes is still unclear. Nucleoside reverse-transcriptase inhibitors (NRTI), drugs approved to treat HIV-1 and hepatitis B infections, also block inflammasome activation. Here, we show, by analyzing five health insurance databases, that the adjusted risk of incident diabetes is 33% lower in patients with NRTI exposure among 128,861 patients with HIV-1 or hepatitis B (adjusted hazard ratio for NRTI exposure, 0.673; 95% confidence interval, 0.638 to 0.710; P < 0.0001; 95% prediction interval, 0.618 to 0.734). Meanwhile, an NRTI, lamivudine, improves insulin sensitivity and reduces inflammasome activation in diabetic and insulin resistance-induced human cells, as well as in mice fed with high-fat chow; mechanistically, inflammasome-activating short interspersed nuclear element (SINE) transcripts are elevated, whereas SINE-catabolizing DICER1 is reduced, in diabetic cells and mice. These data suggest the possibility of repurposing an approved class of drugs for prevention of diabetes.

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Section: Resultssupporting

confidence: 81%

Repurposing anti-inflammasome NRTIs for improving insulin sensitivity and reducing type 2 diabetes development

et al. 2020

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“…Patients with an MPR of 95% or higher were considered adherent to the medication regimen [13][14][15]. The MPR was cut off at "1" for patients with higher than 100% adherence.…”

Section: Introductionmentioning

confidence: 99%

A comparison of medication adherence and viral suppression in antiretroviral treatment-naïve patients with HIV/AIDS depending on the drug formulary

Han

2021

PLoS ONE

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Antiretroviral treatment (ART) adherence is highlighted in management of patients living with human immunodeficiency virus. In South Korea, ART medication research has rarely been conducted due to the low economic burden associated with government-funded treatment. This cross-sectional study aimed to compare the pill burden impact between ART regimen compliance and HIV-RNA viral load suppression. Data were collected from 2008 to 2016 at a general hospital in South Korea. A total of 210 HIV/AIDS treatment-naïve patients were grouped as follows: single-tablet regimen (STR, one tablet/day), mild pill burden (two-four tablets/day), and heavy pill burden (≥ five tablets/day). Patients were analyzed according to gender, age at index date, medical insurance type, comorbidities, depression, HIV/AIDS disease burden as indicated by HIV-RNA viral load and CD4, and laboratory variables. In a multivariate logistic regression model, the STR group demonstrated adherence 5.10 times more often than the heavy pill burden group. Females and patients with an initial viral load of 500,000 or more were 0.090- and 0.040-fold less adherent to the ART regimen. Among these patients, 95% or more of the MPR group were 7.38 times more likely to have a lower limit of detection (LLOD) of viral load suppression. The highest initial viral load group was 0.090-fold less likely to have an LLOD than the reference group. These results suggest that a single-tablet regimen could improve medication adherence and the clinical virologic outcome. Therefore, general population research on ART adherence and polypharmacy is needed.

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“…[2][3][4] Adherence to ART is among the key determinants of viral suppression; however, only 53.6% of patients receiving ART report optimal treatment adherence. 5 Poor adherence may be related to adverse drug effects, high pill burden, complex dosing schedules, food requirements, and/or drug-drug interactions. Current treatment guidelines recommend switching treatmentexperienced patients receiving complex or poorly tolerated regimens to once-daily regimens to increase adherence, improve quality of life, and reduce the likelihood of virologic failure.…”

Section: Introductionmentioning

confidence: 99%

Switching to Doravirine/Lamivudine/Tenofovir Disoproxil Fumarate (DOR/3TC/TDF) Maintains HIV-1 Virologic Suppression Through 48 Weeks: Results of the DRIVE-SHIFT Trial

Johnson

Kumar

Molina

et al. 2019

JAIDS Journal of Acquired Immune Deficiency Syndromes

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for the DRIVE-SHIFT Study Group Background: Doravirine is a novel, nonnucleoside reverse transcriptase inhibitor with demonstrated efficacy in treatmentnaive adults with HIV-1. Methods: In this open-label, active-controlled, noninferiority trial, adults with HIV-1 virologically suppressed for $6 months on 2 nucleoside reverse transcriptase inhibitors plus a boosted protease inhibitor, boosted elvitegravir, or a non-nucleoside reverse transcriptase inhibitor were randomized (2:1) to switch to once-daily, singletablet doravirine 100 mg with lamivudine 300 mg and tenofovir disoproxil fumarate 300 mg (DOR/3TC/TDF) or to continue their current therapy (Baseline Regimen) for 24 weeks. The primary endpoint was the proportion of participants with HIV-1 RNA ,50 copies/mL (defined by the FDA Snapshot approach), with the primary comparison between DOR/3TC/TDF at week 48 and Baseline Regimen at week 24 and a secondary comparison between the groups at week 24 (noninferiority margin, 28%). Results: Six hundred seventy participants (447 DOR/3TC/TDF, 223 Baseline Regimen) were treated and included in the analyses. At week 24, 93.7% on DOR/3TC/TDF vs 94.6% on Baseline Regimen had HIV-1 RNA ,50 copies/mL [difference 20.9 (24.7 to 3.0)]. At week 48, 90.8% on DOR/3TC/TDF had HIV-1 RNA ,50 copies/mL, demonstrating noninferiority vs Baseline Regimen at week 24 [difference 23.8 (27.9 to 0.3)]. In participants on ritonavirboosted protease inhibitor at entry, mean reductions in fasting LDL-C and non-HDL-C at week 24 were significantly greater for DOR/ 3TC/TDF vs Baseline Regimen (P , 0.0001). Adverse events occurred in 68.9% on DOR/3TC/TDF and 52.5% on Baseline Regimen by week 24, leading to treatment discontinuation in 2.5% and 0.4%, respectively. Conclusions: Switching to once-daily DOR/3TC/TDF is a generally well-tolerated option for maintaining viral suppression in patients considering a change in therapy.

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Compliance with clinical guidelines and adherence to antiretroviral therapy among patients living with HIV

Cited by 13 publications

References 34 publications

Repurposing anti-inflammasome NRTIs for improving insulin sensitivity and reducing type 2 diabetes development

Repurposing anti-inflammasome NRTIs for improving insulin sensitivity and reducing type 2 diabetes development

A comparison of medication adherence and viral suppression in antiretroviral treatment-naïve patients with HIV/AIDS depending on the drug formulary

Switching to Doravirine/Lamivudine/Tenofovir Disoproxil Fumarate (DOR/3TC/TDF) Maintains HIV-1 Virologic Suppression Through 48 Weeks: Results of the DRIVE-SHIFT Trial

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