According to research reported at the ASM Microbe Conference Boston June16-20 2016, people who cut back on taking Atripla (TDF/FTC/efavirenz) from daily to three times a week maintained an undetectable viral load for six months. The study was conducted among 61 HIV-positive people who had an undetectable viral load for at least two years (well controlled HIV), had never developed virologic failure (a rise in viral load), and had no known resistance to Atripla’s components.
The participants were randomly assigned to continue taking daily Atripla or to take it only every Monday, Wednesday and Friday for 24 weeks. Researchers measured their viral loads at the study’s outset and at weeks 12 and 24 in both study arms as well as at weeks 1, 2, 4, 6 and 8 in the three-times-per-week arm.
The treatment was well tolerated, with everyone completing the study. According to patient questionnaires and pill counts the participants adhered well to their regimens.
No one in the study developed virologic failure, nor did anyone develop a detectable viral load, even according to a single-copy assay.
At the end of the study, scores on the Pittsburgh Sleep Quality Index improved among those taking Atripla three times a week – the efavirenz component of Atripla is well-known for causing sleep disturbances.
Those taking Atripla less frequently saw their femur (thigh) bone density scores increase slightly, although their lumbar (lower back) spine density did not change. They also experienced an improvement in their kidney biomarkers. Cholesterol levels rose among those taking Atripla less frequently, although to a lesser extent than among those taking the HIV treatment daily.
The study is planned to continue for three years to see if less frequent Atripla can be used as a long-term maintenance regimen, and results need to be confirmed in larger trials.
Comments: The utility of this study may be limited to countries where Atripla is more often used, as it is now a less favoured treatment for use in Australia. In Australia a number of TAF-based treatments are now available or are coming soon, which demonstrate bone and kidney marker improvements over TDF-based treatments like Atripla. However, if you are taking Atripla, it is important to continue to take it daily, as this study is experimental and limited to a precise group of people who were also monitored every 2 weeks for the first 8 weeks due to the risks of the study. If you have any concerns about Atripla dosing, or this study, please discuss them with your prescribing doctor.
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Conference abstract: http://www.abstractsonline.com/pp8/#!/4060/presentation/19726
Source: adapted from https://www.poz.com/article/may-possible-take-atripla-just-three-times-week
