Treatment of HIV infection with once-daily regimens

Treatment for HIV infection requires a lifetime antiretroviral therapy. In order to improve adherence, once daily (OD) is thus a preferred regimen.

Evidence-based information and most recent guidelines recommendation, both from resource-rich and resource-limited settings, on antiretroviral regimens that can be administered OD will be reviewed. Sources of evidences were from the late clinical development studies (Phase III and II) published in Medline or major international conferences.

Nine OD US FDA-approved regimens and one new integrase inhibitor OD regimen have been shown to be efficient and well tolerated. For the fixed-dose single-tablet regimens (STRs), there are two currently approved regimens: Atripla® and Complera®. Another STR elvitegravir/cobicistat/emtricitabine/tenofovir (QUAD, Stribild®) is recently approved by the US FDA (August 20, 2012), whereas two additional SRTs, including abacavir/lamivudine/dolutegravir and darunavir/cobicistat/emtricitabine/GS-7340 are undergoing Phase III and II trials, respectively. Three OD regimens are currently recommended by the US DHHS guidelines as the preferred regimens for treatment-naïve patients (efavirenz, boosted atazanavir and boosted darunavir). EFV-based regimen is the only OD regimen available for resource-limited countries. Nevertheless, it should be noted that each of these OD regimens has its own advantages and disadvantages and therefore should be selected accordingly.