Treatment simplification in HIV-infected adults as a strategy to prevent toxicity, improve adherence, quality of life and decrease healthcare costs

Jean B. Nachega, Michael J. Mugavero, Michele Zeier, Marco Vitória, Joel E. Gallant

Research output: Contribution to journalArticle

Abstract

Since the advent of highly active antiretroviral therapy (HAART), the treatment of human immunodeficiency virus (HIV) infection has become more potent and better tolerated. While the current treatment regimens still have limitations, they are more effective, more convenient, and less toxic than regimens used in the early HAART era, and new agents, formulations and strategies continue to be developed. Simplification of therapy is an option for many patients currently being treated with antiretroviral therapy (ART). The main goals are to reduce pill burden, improve quality of life and enhance medication adherence, while minimizing short- and long-term toxicities, reducing the risk of virologic failure and maximizing cost-effectiveness. ART simplification strategies that are currently used or are under study include the use of once-daily regimens, less toxic drugs, fixed-dose coformulations and induction-maintenance approaches. Improved adherence and persistence have been observed with the adoption of some of these strategies. The role of regimen simplification has implications not only for individual patients, but also for health care policy. With increased interest in ART regimen simplification, it is critical to study not only implications for individual tolerability, toxicity, adherence, persistence and virologic efficacy, but also cost, scalability, and potential for dissemination and implementation, such that limited human and financial resources are optimally allocated for maximal efficiency, coverage and sustainability of global HIV/AIDS treatment.

Original languageEnglish (US)
Pages (from-to)357-367
Number of pages11
JournalPatient Preference and Adherence
Volume5
DOIs
StatePublished - 2011

Fingerprint

Health Care Costs
quality of life
Quality of Life
HIV
costs
Poisons
Highly Active Antiretroviral Therapy
persistence
Therapeutics
Medication Adherence
induction
Virus Diseases
Health Policy
Secondary Prevention
AIDS
medication
Cost-Benefit Analysis
coverage
sustainability
Acquired Immunodeficiency Syndrome

Keywords

  • Adherence
  • ART
  • Coformulations
  • Healthcare cost
  • Once-daily
  • Persistence
  • Quality of life
  • Simplification

ASJC Scopus subject areas

  • Social Sciences (miscellaneous)
  • Medicine (miscellaneous)
  • Health Policy
  • Pharmacology, Toxicology and Pharmaceutics (miscellaneous)

Cite this

Treatment simplification in HIV-infected adults as a strategy to prevent toxicity, improve adherence, quality of life and decrease healthcare costs. / Nachega, Jean B.; Mugavero, Michael J.; Zeier, Michele; Vitória, Marco; Gallant, Joel E.

In: Patient Preference and Adherence, Vol. 5, 2011, p. 357-367.

Research output: Contribution to journalArticle

Nachega, Jean B. ; Mugavero, Michael J. ; Zeier, Michele ; Vitória, Marco ; Gallant, Joel E. / Treatment simplification in HIV-infected adults as a strategy to prevent toxicity, improve adherence, quality of life and decrease healthcare costs. In: Patient Preference and Adherence. 2011 ; Vol. 5. pp. 357-367.
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