Influence of Treatment Complexity on Adherence and Incidence of Blips in HIV/HCV Coinfected Patients

Abstract

BACKGROUND: The addition of antihepatitis C therapy to highly active antiretroviral treatment (HAART) in human immunodeficiency virus (HIV)/hepatitis C virus (HCV) coinfected patients leads to an increase in the treatment complexity that may result in decreased adherence. Blips, defined as intermittent episodes of detectable low-level HIV viremia, may be an indication of poor adherence to HAART.

Validation and standardization of the Brazilian version of the Medication Regimen Complexity Index for older adults in primary care

“…This result corroborates the importance of using a validated tool, consisting of realms that evaluate different aspects of pharmacotherapy for the measurement of complexity . Thus, medication number alone is not sufficient to measure the level of difficulty of using a medication therapy . Pharmacotherapy with fewer medications, but with a high frequency of daily administration, might be more complex than a pharmacotherapy with a greater number of medications, all administered only once a day …”

“…26 Thus, medication number alone is not sufficient to measure the level of difficulty of using a medication therapy. [14][15][16][17][18][19][20][21][22][23][24][25][26][27] Pharmacotherapy with fewer medications, but with a high frequency of daily administration, might be more complex than a pharmacotherapy with a greater number of medications, all administered only once a day. 28 Reliability analyses showed an excellent agreement between the scores obtained by the same and by different evaluators.…”

Treatment adherence and virological response rates in hepatitis C virus infected persons treated with sofosbuvir‐based regimens: results from ERCHIVES

“…The pill burden and drug–drug interactions with the first generation of DAAs (boceprevir and telaprevir) posed challenges to clinicians and patients. At least one potential drug–drug interaction was found in more than half of the patients on these drugs, and those with the drug–drug interaction were less likely to be adherent to therapy and have a lower SVR rate . Conversely, treatment for HCV itself is associated with increased adherence to highly active antiretroviral therapy in patients co‐infected with the human immunodeficiency virus .…”

Therapeutic burden in interstitial lung disease: Lessons to learn

“…Most disease‐targeted therapies for ILD have specific administration instructions with dose‐titration and food‐dosing requirement. Previous study in patients with HIV found that medication regimens with more complex administration instructions were associated with higher rates of non‐adherence . As shown in patients with osteoporosis, poor adherence to dosing instructions for bisphosphonates is common despite good compliance to the treatment .…”