had Comparable Immunological Virological and Adherence Potential with Single Drug C ombinations Avong YK 1 Jatau B 1 Ekong E 1 Ndembi N 1 Okuma J 1 ID: 809297
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Fixed Dose Combination Anti-retroviral Drugs had Comparable Immunological, Virological and Adherence Potential with Single Drug CombinationsAvong YK1, Jatau B1, Ekong E1, Ndembi N1, Okuma J1, Avong EB2, Ogbanufe O3, Gurumnaan R1, Adebamowo C1,4, Mensah C1, Dakum P1 , Blattner W41.Institute of Human Virology, Nigeria, Maina Court, Herbert Macaulay Way, Abuja, Nigeria 2. Wise Health Services Limited, Zone 4, Wuse, Nigeria3. United States Centers for Disease Control and Prevention, Abuja, Nigeria 4. University of Maryland School of Medicine, Baltimore, MD 21201, USA
5
th
World Congress on Virology, December 07-09, 2015, Atlanta,
USA
Slide2IntroductionART has destroyed Coffin business in most African countriesAll patients starting ART are able to achieve sustained HIV RNA plasma viral loads below 20 copies per milliliter
Slide3WHO Treatment PolicyFixed Dose Combinations (FDC) anti-retroviral drugs are preferred over Single Dose Combinations (SDC)Reasons: FDCs have fewer pills to and are thought to promote adherence to ARTMost countries have deleted the single anti-retroviral drugs in their ART formulariesProblem: Poly-pharmacy = drug-drug interactions & additive toxicities.
Slide4AimWe investigated whether FDCs have superior adherence effects and virologic suppression over the SDCs.
Slide5Methods501 people living with HIV/AIDS were prescribed FDCs and SDCs.FDCs: AZT/3TC/NVP; 3TC/NVP/d4T; Pill burden: 2 pills dailySDCs:AZT/3TC +NVP or EFV; TDF/FTC +EFV or NVP; TDF+3TC+LPV/r. Pill burden: 8 pills daily
Slide6MethodsAdherence = taking 95% or more of medications in correct doses & frequencyVirologic Suppression = achieving a HIV-1 RNA of 400copies/mlPropensity score method was used to randomly assigned participants into the FDCs or SDCsApplied Logistic regression to compare adherence rate and virologic suppression in the two cohorts
Slide7Results
Slide8DiscussionAdherence and virologic suppression were not different among the FDCs and SDC users. SDCs should be retained alongside the FDCs in resource limited settings.
Slide9AcknowledgementInstitute of Human Virology, Nigeria – for the opportunity to conduct the studyProf Ting-Chao Chou – for outstanding work in Pharmacodynamics and Combination Therapy.Prof William Blattner – for reviewing and approving the work