Treatment Adherence And Persistence Among HIV-1 Patients Newly Starting Treatment

Area of Science:

• Infectious Diseases
• Pharmacology
• Public Health

Background:

• Antiretroviral therapy (ART) is crucial for managing HIV-1 infection.
• Adherence and persistence with ART regimens are key determinants of treatment success.
• Single-tablet regimens (STRs) and multi-tablet regimens (MTRs) represent different approaches to ART delivery.

Purpose of the Study:

• To compare adherence and persistence between first-line STRs and MTRs in HIV-1 patients.
• To identify factors influencing adherence and persistence in newly treated patients.
• To evaluate the effectiveness of different ART formulations in real-world settings.

Main Methods:

• Retrospective analysis of US pharmacy claims data from 2016-2016.
• Inclusion of newly treated HIV-1 patients initiating ART.
• Assessment of adherence (proportion of days covered) and persistence (time to discontinuation) over 12 months.
• Utilized Kaplan-Meier curves and Cox Proportional Hazard models for discontinuation analysis.

Main Results:

• STR users demonstrated significantly higher adherence rates (24.9%) compared to MTR users (11.7%).
• STRs were associated with greater persistence, with MTR patients being 61% more likely to discontinue therapy.
• Specific regimens like EVG/COBI/FTC/TAF (STR) and FTC/TDF+DTG (MTR) showed better adherence.
• Younger age, female gender, and Medicare/Medicaid insurance predicted treatment discontinuation.

Conclusions:

• STRs offer superior adherence and persistence compared to MTRs in first-line HIV-1 treatment.
• A substantial proportion of patients experienced treatment interruptions or discontinuation, highlighting ongoing challenges.
• Further research into post-first-line treatment patterns is necessary to optimize long-term HIV management.