A simplified combination antiretroviral therapy regimen enhances adherence, treatment satisfaction and quality of life: Results of a randomized clinical trial

Abstract

Objectives: The aim of the study was to investigate the effect of a simplified regimen, in terms of reducing pill burden, dietary requirements and possible adverse effects, on patients' adherence, treatment satisfaction and quality of life (QoL). Methods: Antiretroviral-naïve patients who achieved a viral load <50 HIV-1 RNA copies/ml after induction therapy with twice-daily (bid) lopinavir/ritonavir (LPV/r) and fixed-dose zidovudine (ZDV)/lamivudine (3TC) (CBV) were randomly assigned to continue CBV/LPV/r or switch to fixed-dose ZDV/3TC/abacavir (TZV). Patients completed standardized questionnaires on adherence, treatment satisfaction and QoL at randomization (between weeks 12 and 24) and at weeks 48, 72 and 96. Results: Patients on CBV/LPV/r were more likely to have skipped medicines in the last week (P=0.035) and during the preceding weekend (P=0.027) than patients on TZV. Patients on CBV/LPV/r were significantly less satisfied with the convenience of their treatment (P=0.004) and tended to be less satisfied with the side effects of their treatment (P=0.091) and continuation of their present treatment (P=0.056) than patients on TZV. Patients on CBV/LPV/r reported significantly lower levels of role functioning (P=0.013) than patients on TZV. Conclusions: In this randomized controlled trial, simplification of therapy to fixed-dose TZV among patients with suppressed HIV RNA was perceived to be more convenient, and resulted in improved adherence and better role functioning, than continuing treatment with CBV/LPV/r. © 2013 British HIV Association.