PROs Assessment in Dual (Either Oral or Injectable) Antiretroviral Regimen in People with HIV: A Narrative Review

With modern antiretroviral regimens, durable viral suppression is now achieved in most people with HIV (PWH), whose life expectancy approaches that of the general population. Consequently, recent guidelines emphasise, beyond virological and immunological control, health-related quality of life and patient-reported outcomes (PROs) as targets of HIV care, including for dual regimens.

We conducted a narrative review of clinical trials and observational studies evaluating PROs in adults treated with dual antiretroviral therapies, either oral or long-acting injectable. We also examined guideline documents and implementation studies addressing the role, feasibility, and interpretation of PROs in routine HIV care.

Trials of dual regimens reported high treatment satisfaction, convenience, and stable or improved quality of life, with some concerns related to injection-site reactions and visit burden for long-acting formulations. Emerging real-world data broadly confirm these findings but remain heterogeneous, with variability in instruments, assessment timing, and analytic approaches, limiting comparability and clinical use.

PROs may support shared decision-making and optimise the use of dual therapies in PWH, but their uptake in clinical practice is still limited. Standardised tools, clearer interpretative frameworks, and pragmatic implementation strategies are needed to better integrate PROs into everyday HIV care.