Dissolved Bictegravir/Emtricitabine/Tenofovir Alafenamide Improves Medication Adherence

Area of Science:

• Pediatric infectious diseases
• HIV/AIDS treatment
• Pharmacology

Background:

• Single-tablet regimens (STRs) for perinatally-acquired HIV in pediatric patients lag behind adult availability.
• Pediatric patients often present with complex care needs, complicating treatment adherence.
• Limited pediatric-specific formulations pose challenges for effective HIV management.

Purpose of the Study:

• To report the first known case of dissolved low-dose bictegravir/emtricitabine/tenofovir alafenamide (STR) in a pediatric patient.
• To evaluate the efficacy and safety of a dissolved STR formulation in a child with complex medical conditions.
• To assess the impact of a dissolved STR on medication adherence in pediatric HIV care.

Main Methods:

• A 7-year-old male with perinatally-acquired HIV, developmental delay, seizure disorder, and oral-motor dysfunction was treated.
• Caregivers dissolved a low-dose bictegravir/emtricitabine/tenofovir alafenamide STR to facilitate administration.
• Follow-up included assessment of virologic suppression, adverse events, and adherence via parental report and pharmacy refills.

Main Results:

• The dissolved STR formulation maintained virologic suppression in the pediatric patient.
• No adverse side effects were reported with the dissolved medication.
• Medication adherence improved, based on parental reports and pharmacy refill data.

Conclusions:

• Dissolving low-dose bictegravir/emtricitabine/tenofovir alafenamide STRs is a feasible strategy for pediatric HIV management.
• This method can improve adherence and maintain viral suppression in children with complex needs.
• This case highlights a novel approach to pediatric antiretroviral therapy administration.