Related Experiment Videos
Once-a-day highly active antiretroviral therapy: a systematic review
Javier Ena1, Francisco Pasquau
1HIV Unit, Department of Internal Medicine, Marina Baixa Hospital, Villajoyosa, Alicante, Spain. ena_jav@gva.es
Insights
Once-daily highly active antiretroviral therapy (HAART) demonstrates strong virological efficacy, comparable to conventional HAART. These simplified regimens also show good tolerability and a significant increase in CD4 cell counts.
Area of Science:
- Infectious Diseases
- Virology
- Pharmacology
Background:
- Highly active antiretroviral therapy (HAART) is crucial for managing HIV/AIDS.
- Simplifying HAART regimens can improve patient adherence and outcomes.
- Evaluating once-daily dosing strategies is essential for optimizing treatment.
Purpose of the Study:
- To assess the efficacy and tolerability of once-daily HAART regimens.
- To compare once-daily HAART with conventional dosing schedules.
- To analyze virological outcomes and CD4 cell count changes.
Main Methods:
- Systematic review of available evidence including uncontrolled and randomized clinical trials.
- Inclusion criteria: at least 24 weeks duration and 80% participant follow-up.
- Analysis of various once-daily HAART combinations including didanosine (ddI), emtricitabine (FTC), lamivudine (3TC), and efavirenz (EFV).
Main Results:
- Virological efficacy ranged from 70% to 91%.
- Once-daily regimens (ddI, 3TC, EFV or ddI, FTC, EFV) showed efficacy similar to conventional HAART.
- Significant CD4 cell increase of at least 114 lymphocytes/microL observed.
- Good tolerability with a low discontinuation rate.
Conclusions:
- Once-daily HAART regimens are effective and well-tolerated.
- Simplified dosing strategies offer a viable alternative to conventional HAART.
- Further research into long-term outcomes of once-daily HAART is warranted.
Abstract:
We analyzed the available evidence about the efficacy and tolerability of once-a-day highly active antiretroviral therapy (HAART), searching databases, conference proceedings, and journals. Two reviewers independently selected 6 uncontrolled and 2 randomized clinical trials of at least 24 weeks duration and with 80% participant follow-up. Regimens included didanosine (ddI), emtricitabine (FTC), and efavirenz (EFV) (2 studies, 326 patients); ddI, lamivudine (3TC), and EFV (3 studies, 147 patients); ddI, 3TC, EFV, and adefovir dipivoxil (1 study, 11 patients); ddI, nevirapine, and EFV (1 study, 15 patients); and ddI, 3TC, indinavir, and ritonavir (1 study, 10 patients). Virological efficacy ranged between 70% and 91%. Preliminary randomized clinical trials showed that once-a-day regimens (ddI, 3TC, and EFV or ddI, FTC, and EFV) had a virological efficacy at least similar to that of conventional HAART. The overall CD4 cell increase was at least 114 lymphocytes/microL. Tolerability was good, with a low discontinuation rate.