Case study shows importance of single-pill HIV-1 treatment
(HealthDay)—A single-pill combination HIV-1 treatment may be appropriate in certain cases, according to a case vignette published in the July 17 issue of the New England Journal of Medicine.
Monica Gandhi, M.D., M.P.H., from the University of California in San Francisco, and Rajesh T. Gandhi, M.D., from Massachusetts General Hospital in Boston, discuss the case of a 52-year-old homeless man who was diagnosed with HIV-1 infection in 2005. The patient was recently prescribed a multi-pill antiretroviral regimen, which he had not followed. The patient, who did not take other medications and had normal renal function, would take his medication if it was limited to a single pill once a day.
The authors discuss the currently available single-pill combinations marketed for HIV-1 treatment, each of which contains the same combination of one nucleotide reverse-transcriptase inhibitor and one nucleoside reverse-transcriptase inhibitor. After checking the HIV-1 genotype of the patient for drug resistance, a single-pill combination could be beneficial in this case. Tenofovir disoproxil fumarate and emtricitabine would be a reasonable option as a backbone in the single-pill combination, and any of the anchor drugs would be suitable for this patient, based on his having normal renal function.
"The selection of a regimen should be based on potential side effects, food requirements, dosing schedule, and, possibly, anticipated adherence; cost may also be a consideration," the authors write.
One author disclosed financial ties to the pharmaceutical industry.
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