Patient-reported outcomes among people living with HIV on single- versus multi-tablet regimens

Background: Single-tablet regimens (STR) have become the golden standard in antiretroviral therapy. However, there are calls to reintroduce (generic) components as multi-tablet regimens (MTR) because of cost-savings. Patient-reported outcome measures (PROs) are an important touchstone to support or to renounce this proposal. As such, our aim was to compare PROs of people living with HIV taking an STR versus a MTR in a real world setting.

Materials and methods: 188 people living with HIV participated in a longitudinal study. 132 remained on their MTR and 56 switched to an STR. At baseline, months 1-3-6-12-18 and 24, participants filled in questionnaires on health-related quality of life (HRQoL), depressive symptoms, HIV symptoms, neurocognitive complaints (NCC) treatment satisfaction and adherence. Generalized linear mixed models and generalized estimation equations mixed models were built.

Results: At baseline, the two groups did not differ in clinical parameters and PROs. The mixed models revealed differences among the groups regarding neurocognitive complaints and treatment satisfaction. The odds of having NCC increased by 4,1% per month in the STR-group as compared to the MTR-group (p=0.035). Nonetheless, treatment satisfaction also increased in the STR-group: at month 6, median change score was highly positive: 24 (IQR 7,5-29). Treatment satisfaction showed a significantly different evolution in the groups: the estimated state score increased by 3,3 in the STR-group while it decreased by 0,2 in the MTR-group (p=0.003). HRQoL measures, HIV symptoms, depressive symptoms and adherence did not differ between the groups over time.

Conclusions: Neurocognitive complaints and treatment satisfaction differed between the two groups. More people on an STR reported NCC over time compared to the MTR-group. Contrarily, treatment satisfaction in the STR-group increased significantly over time. It should be further investigated to which extent treatment satisfaction is a predictor for long-term treatment persistence and health outcomes.