Single Tablet Regimen Usage and Efficacy in the Treatment of HIV Infection in Australia

Single tablet regimens (STRs) for HIV infection improve patient satisfaction, quality of life, medication adherence, and virological suppression compared to multitablet regimens (MTRs). 

This is the first study assessing STR uptake and durability in Australia. This retrospective audit of all patients receiving an STR (n = 299) at a large Sydney HIV clinic (January 2012-December 2013) assessed patient demographics, treatment prior to STR, HIV RNA load and CD4 during MTR and STR dosing, and reasons for STR switch. 206 patients switched from previous antiretroviral treatment to an STR, of which 88% switched from an MTR. 

Reasons for switching included desire to simplify treatment (57%), reduced side effects or toxicity (18%), and cost-saving for the patient. There was no switching for virological failure. Compared to when on an MTR, patients switching to an STR had significantly lower HIV RNA counts (p < 0.001) and significantly higher CD4 counts (p < 0.001). 

The discontinuation rate from STR was very low and all patients who switched to an STR maintained virological suppression throughout the study duration, although the study is limited by the absence of a control group.

Table 1

Disposition of ARV switch to STR.

	N
Patients receiving STR	299
Patients switched to STR	206
Previous regimen type
MTR	182
STR	23
Treatment interruption	1
STR switched to (from previous regimen)
Eviplera/Complera	111
From MTR	83
From Atripla	23
From medication trials∗	4
From prolonged treatment interruption	1
Atripla	95
From MTR	93
From medication trials∗	2

∗Patients switched from medication trials categorised as MTR for statistical analysis.

Below:  Durability of STRs over 24 months (n = 299)

Full article at:  http://goo.gl/XGpD4O

By:  Armstrong B1, Chan DJ2, Stewart MJ3, Fagan D4, Smith D2.

• 1Graduate School of Medicine, University of Wollongong, Wollongong, NSW 2522, Australia ; St George Hospital, South East Sydney Local Health District, Sydney, NSW 2217, Australia.
• 2Albion Centre, South East Sydney Local Health District, Sydney, NSW 2010, Australia ; School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW 2052, Australia.
• 3Albion Centre, South East Sydney Local Health District, Sydney, NSW 2010, Australia.
• 4Albion Centre, South East Sydney Local Health District, Sydney, NSW 2010, Australia ; Discipline of Pharmacy, Faculty of Health, University of Canberra, Canberra, ACT 2617, Australia. 

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