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A simplified combination antiretroviral therapy regimen enhances adherence, treatment satisfaction and quality of life: results of a randomized clinical trial
Author(s) -
Langebeek N,
Sprenger HG,
Gisolf EH,
Reiss P,
Sprangers MAG,
Legrand JC,
Richter C,
Nieuwkerk PT
Publication year - 2014
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12112
Subject(s) - medicine , regimen , lopinavir , fixed dose combination , adverse effect , lopinavir/ritonavir , randomized controlled trial , ritonavir , viral load , zidovudine , pill , randomization , abacavir , quality of life (healthcare) , antiretroviral therapy , human immunodeficiency virus (hiv) , pharmacology , immunology , viral disease , nursing
Objectives The aim of the study was to investigate the effect of a simplified regimen, in terms of reducing pill burden, dietary requirements and possible adverse effects, on patients' adherence, treatment satisfaction and quality of life ( QoL ). Methods Antiretroviral‐naïve patients who achieved a viral load < 50 HIV ‐1 RNA copies/ml after induction therapy with twice‐daily (bid) lopinavir/ritonavir ( LPV /r) and fixed‐dose zidovudine ( ZDV )/lamivudine ( 3TC ) ( CBV ) were randomly assigned to continue CBV / LPV /r or switch to fixed‐dose ZDV / 3TC /abacavir ( TZV ). Patients completed standardized questionnaires on adherence, treatment satisfaction and QoL at randomization (between weeks 12 and 24) and at weeks 48, 72 and 96. Results Patients on CBV / LPV /r were more likely to have skipped medicines in the last week ( P = 0.035) and during the preceding weekend ( P = 0.027) than patients on TZV . Patients on CBV / LPV /r were significantly less satisfied with the convenience of their treatment ( P = 0.004) and tended to be less satisfied with the side effects of their treatment ( P = 0.091) and continuation of their present treatment ( P = 0.056) than patients on TZV . Patients on CBV / LPV /r reported significantly lower levels of role functioning ( P = 0.013) than patients on TZV . Conclusions In this randomized controlled trial, simplification of therapy to fixed‐dose TZV among patients with suppressed HIV RNA was perceived to be more convenient, and resulted in improved adherence and better role functioning, than continuing treatment with CBV / LPV /r.