Patient-Reported Treatment Satisfaction and Quality of Life Among People Living with HIV Following the Introduction of Dolutegravir-Based ART Regimens in Ukraine

Abstract

In 2017, the government of Ukraine initiated its ART Optimization Initiative, revising its national antiretroviral therapy (ART) guidelines and embracing Dolutegravir (DTG) as a backbone of first-line ART regimens. A cross-sectional survey of 464 ART patients from 22 large ART clinics was carried out in mid-2019. The survey assessed patient-reported outcomes (PROS) including treatment satisfaction, physical health, mental health, depression, side effects of ART, and adherence. The associations between ART regimen and PROs were assessed using bivariable and multivariable generalized estimating equations (GEE) models. More than half (55.6%) of the patients were satisfied with their current ART regimen. Less than a half (45.3%) considered their physical health as good while only 36.9% rated their mental health as good, 21.3% reported moderate or severe depression, 82.3% reported no side effect in the past 4 weeks, and 44.4% reported not missing ART medication in the past month. In adjusted analysis, patients starting ART with DTG had higher treatment satisfaction compared to people continuing LPV-based regimens (aOR = 0.49, 95% confidence interval: 0.22-0.90). Also in adjusted analyses, unemployment, low income, and history of injection drug use were associated with unfavorable PROs. While the results indicate modestly favorable effects of ART Optimization, there is clearly a need for complementary interventions to improve PROs among disadvantaged ART patients in Ukraine.

Quality of Life and Associated Factors of HIV Patients Under Treatment with First Line Regimens in Public Hospitals in Amhara Region, North-West Ethiopia

“…Even if he/she takes the drug on time the substance they take may affect the effectiveness of the drugs taken. 33 …”

Preliminary report on the provision of HIV care to war refugees with HIV who are migrating from Ukraine: data from the ECEE Network Group

“…Pharmacologic monitoring of adherence to these regimens provides an objective measurement of compliance and has been shown to predict the efficacy of PrEP [4,8]. Current methods to measure drugs rely on complex analytical tests using liquid chromatography and tandem mass spectrometry that are costly, require skilled personnel, and are not implementable at point-of-care (POC) testing sites [9][10][11]. Furthermore, due to limitations in self-reporting and pill-counting methods of adherence monitoring [12,13], a direct method for measuring FTC levels provides an objective marker that could have broad implications on the ability of care providers to monitor and counsel adherence to ART and PrEP [14].…”

“…In terms of accessibility of ART, 36% of the centers could only provide ART available in their national program, which resulted in switching. The majority of people living with HIV in Ukraine receive generic DTG/TDF/3TC treatment procured within a Pooled Patent Mechanism [10]. However, in the majority of surveyed countries, it is available only as a much more expensive brand product, and, in three countries, can be prescribed with specific restrictions.…”

Comparative Clinical Outcomes With Scale-up of Dolutegravir as First-Line Antiretroviral Therapy in Ukraine

“…An overview of DTG implementation in Ukraine and the results of the patient survey from this evaluation are reported elsewhere. 12,13 This study compared HIV VS and 12-month retention among PLWH newly initiating ART using DTG-based regimens compared with first-line ART regimens, which used ritonavir-boosted lopinavir (LPV/r) or efavirenz (EFV).…”