Treatment simplification
Treatment simplification refers to the use of regimens that are easier to take. This may include regimens with fewer drugs, a lower ‘pill burden’ or drugs that are taken less often. Some drugs have been put together in fixed-dose combination pills that enable patients to take fewer total tablets or capsules. The recently approved Atripla pill (tenofovir/emtricitabine/efavirenz), for example, offers a one-pill, once-daily regimen for people starting treatment for the first time. For some protease inhibitors, a reduction in pill counts and dose frequency has been accomplished by ‘boosting’ drug levels in the body by adding a small dose of ritonavir (Norvir).
As a rule, simplification strategies are most appropriate for people who are new to treatment and have less advanced HIV disease. Simplified regimens are not for everyone, especially highly treatment experienced patients whose virus has developed extensive drug resistance.
Considerations for treatment simplification are discussed further in Changing HIV Therapy.
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