Finally, the cost of the newest compound, often higher than older ones, may constitute a drawback to the use of STRs, forcing national regulatory agencies to put limitations on their prescriptions [79] or ceilings to their use. Conclusion One of the challenges of HIV infection management remains to encourage and enable patients to take ARV drugs correctly for a lifetime. Selection of a regimen should

be individualized on the basis of virologic efficacy, KPT-8602 concentration toxicity, pill burden, dosing frequency, drug–drug interaction potential, resistance testing results, and comorbid conditions [43]. Simplicity of treatment is a key point and the combination of several active ARV agents in a single pill is a way to comply with the above considerations and offers potential advantages. These advantages, besides the improved all-around adherence, include a selleck inhibitor reduced risk of selective non-compliance, a reduced risk of prescription error, a reduced risk to expose the patient to general stigma by allowing an improved privacy and an increased acceptability, all of which might decrease the likelihood of

treatment failure and subsequent selection of drug resistance. Results of surveys show that patients prefer to take fewer daily pills, and look for compact easy-to-use regimens; A-1155463 datasheet observational and controlled Glutathione peroxidase studies indicate that virological and clinical outcomes are improved in individuals treated with single vs. MPRs, even among difficult-to-treat populations. In many cases, STRs also show economic benefit compared to other

available regimens. The choice of the initial ARV regimen is a cornerstone of the correct management of HIV infection as it may influence all the subsequent choices and residual options. Individualization of therapy is of utmost importance. It may be counterintuitive to claim the possibility to individualize treatment through the use of fixed-dose combinations, however, excluding infrequent cases (e.g., severe renal impairment or specific drug interactions); individualization is not based on the reduction/increment of doses, but rather on the choice of pharmacological components of the regimen. Therefore, the available STRs, based on the combination of different drug classes, allow prescribers to individualize treatment in naïve patients. As an example: TDF/FTC/COBI/EVG could be used in a wide variety of naïve subjects without limitations based on their pre-treatment viral load or their immunological status. In the event of a reduced eGFR (<70 ml/min), TDF/FTC/RPV [71] appears a good alternative choice for the treatment of naïve patients, provided their baseline viral load is ≤100,000 copies/mL, in the latter case TDF/FTC/EFV could result in being the preferred STR.