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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update
UNITED STATES: Higher Pill Burden Is Associated with Poorer Adherence to HIV Therapy and Reduced Chances of Achieving an Undetectable Viral Load
By Michael Carter
February 7, 2014
NAM aidsmap (01.31.2014)

NAM aidsmap reported on a study that investigated whether pill burden and dosing schedule affected adherence to antiretroviral therapy (ART) and virologic suppression in HIV-positive individuals. The researchers conducted a meta-analysis of 19 randomized-controlled studies with 6,312 individuals that occurred between 2004 and 2011. None of the studies used fixed-dose single pill therapy. The participants in seven studies were treatment-naïve individuals; participants in nine were patients with undetectable viral loads who changed treatment; and participants in three changed treatment after their viral load became detectable. Median duration of follow-up was 48 weeks. Eleven studies used the Medication Event Monitoring System to assess adherence, while eight used pill count. Results showed that once-daily treatment was associated with higher rates of adherence compared to twice-daily treatment, but virologic outcomes did not differ significantly. Higher pill burden was associated with lower rates of adherence and poor virologic outcomes for twice-daily treatment. The researchers believe the findings may be of interest to healthcare systems that are considering ways of reducing expenditure. The full report, “Lower Pill Burden and Once-Daily Dosing Antiretroviral Treatment Regimens for HIV Infection: A Meta-Analysis of Randomized Controlled Trials,” was published online ahead of print in the journal Clinical Infectious Diseases (2014; doi: 10.1093/cid/ciu046).