The magazine AIDS Rev has published an article entitled Once-Daily Single-Tablet regimes: A Long and Winding Road to Excellence in Antiretroviral Treatment, where doctors Josep Maria Llibre and Bonaventura Clotet make a review of the treatments of this type that currently exist and the ones that are in the process of approval for the next two years.
HIV infection represents having to take antiretroviral therapy throughout life and it is vital that, from the outset, the patient has a good adherence to treatment. People who do not follow it properly are more likely to suffer an increase in the viral load (amount of HIV in the blood) and to make their infection progress. In the last decade there has been progress in terms of simplification of antiretroviral treatment. Reductions in the number of daily doses and pills to take, doses once a day and reduction of the toxic effects of drugs and other improvements have facilitated the adherence to treatment.
Regimes or patterns in one pill, once a day, represent the highest level of simplification achieved with regard to antiretroviral therapy. This type of treatment includes drugs with favorable pharmacokinetics (long lasting effect and a good relationship between blood levels of the drug and its therapeutic effects) to administer them only once a day without adjusting its dose and without additional toxicity.
Since its approval in 2006, the co-formulation of efavirenz / tenofovir disoproxil fumarate / emtricitabine in a single pill has been a standard at the time of initiating antiretroviral therapy. In some patients, however, this was not the optimal therapy for various conditions, or intolerance or resistance to therapy. Research that has been developed and several agreements in the pharmaceutical industry patents allow the emergence of new treatment regimens in a single pill containing combinations of drugs from different families (reverse transcriptase inhibitors, integrase inhibitors, and protease inhibitors). Patients with HIV will have more options to reduce the number of pills to be taken daily and to optimize their therapy. Even if they don't tolerate a drug or if their virus is resistant, they may also benefit from simplified treatment options in one tablet once a day.