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Doltegravir/Abaravir/Lamividune

Criteria
#
1
2

Efficacy

Points

Reduction or supression of plasma HIV 1 and 2 viral


load

Maintenance of a higher CD4 count

3
4

Minimal resistance to the drug


+
Clinical trial evidence in ART nave patients with
+
favorable response
In the SINGLE trial, efficacy of DTG/ABC/3TC was compared with
the single table regimen of TDF/FTC/EFV IN 833 ART-nave patients. At
48 weeks, 88% of patients receiving DTG and 81% on EFV had plasma
HIV-RA of <50 copies/mL (p=0.003). Patients in the DTG arm also
experienced significantly shorter median times to viral suppression (28
vs 84 days, p<0.0001), as well as greater increases in CD4 counts (268
vs 208 cells/uL, respectively; p<0.001). It is also noteworthy that none
of the ART-nave patients receiving DTG/ABC/3TC in the ISNGLE trial
developed resistance to DTG upon early virologic failure. Givebn that
ABC will be co-formulated with DTG, HLA-B*5701 genetic testing must
be carried our before prescribing the STR in order to identify patients
at risk for developing ABC-associated hypersensitivity reactions
(Fernandez-Montero, et al, 2014)
Criteria
1

Safety

Points

Absent to minimal temporary/reversible side effects

Absent to minimal risk of organ toxicity or damage

No associated or rare life threatening ADRs

Minimal drug-drug interactions

2
3
4
When considering the use of DTG/ABC/3TC, dat from the SINGLE
trial showed very reassuring results in ART-nave patients. Grade 3-4
adverse effects events were reported in 10% of patients on DTG in
comparison with 16% of subjects receiving EFV. DTG arm reported 43%

versus the EFV arm with 66% of all-grade drug-related side effects,
with significantly lower incidence of neuropsychiatric and skin adverse
events. Most commonly reported adverse events in DTG arm were
diarrhea, insomnia, nasopharyngitis and nausea (Fernandez-Montero,
et al, 2014).
Criteria
1

Necessity

Points

Targets both HIV 1 and 2

High rate of adherence to the drug

2
3
Convenience
schedule)

of

administration (dosage form

and

4
Minimal resistance to the drug

DTG/ABC/3ATC is a drug available for HIV1 infection. Overall, 2% of


patients on DTG arm and 10% on EFV discontinued therapy due to adverse
effecrs. DTG has short absorption time, with a time to maximum
concentration (Tmax) of 1 hour. However, DTG has a longer serum half-life of
15 hours, which makes possible one-daily dosing. Time to steady-state
concentration was 7 days (Fernandez-Montero, et al, 2014).

Criteria
1

Affordability
PHP 1 P 19,999 per month

Points
++++

2
PHP 20,000 39,999 per month

+++

PHP 40,000 59,999 per month

++

3
4
PHP > 60,000
The cost of a month-treatment of DTG/ABC/3TC is approximately
___ for 1 tablet intake once a day.
Reference:
1. http://www.researchgate.net/publication/261799495_Dolutegravir
_abacavir_and_lamivudine_as_HIV_therapy

TENOFOVIR/EMITRCITABINE
Criteria
#
1

Efficacy

Points

Reduction or supression of plasma HIV 1 and 2 viral


load

Maintenance of a higher CD4 count

3
4

Minimal resistance to the drug


Clinical trial evidence in ART nave patients with
favorable response

+
+

In the study conducted in India for both ART nave and ART experienced
patients, the median change in CD4 counts at 6 and 12 months among ARV-naive patients was
+168 cells/microliter (mcL) and +368 cells/mcL, respectively.

Criteria
1

Safety

Points

Absent to minimal temporary/reversible side effects

Absent to minimal risk of organ toxicity or damage

No associated or rare life threatening ADRs

Minimal drug-drug interactions

2
3
4

Criteria
1

Necessity

Points

Targets both HIV 1 and 2

High rate of adherence to the drug

2
3
Convenience
schedule)

of

administration (dosage form

and

4
+
Approved by the FDA in 2001, Tenofovir is a nucleotide analog of deoxyadenosine
monophosphate, with activity against HIV-1, -2 and Hepatitis B virus (HBV) (Mulato and
Cherrington 1997; Robbins et al 1998). Because of its long half-life (17 hours), it is
administered once daily with other antiretroviral drugs.

Criteria
1

Affordability
PHP 1 P 19,999 per month

Points
++++

2
PHP 20,000 39,999 per month

+++

PHP 40,000 59,999 per month

++

3
4
PHP > 60,000

Criteri
a#

Necessity

PHP 1 P 19,999 per month

PHP 20,000 39,999 per month

Points

++++
+++

PHP 40,000 59,999 per month

PHP > 60,000

++
+

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