title: Simplification of HAART therapy on ambulatory HIV patients in Malaysia:a randomized controlled trial.
abstract: OBJECTIVE
  Evaluate the impact of fixed-dose combination (FDC) containing emtricitabine (FTC), tenofovir (TDF), and efavirenz (EFV) versus a free-dose combination (FRC) of the same three drugs on clinical outcomes, adherence and quality of life in Malaysian outpatients with HIV.
  
  
  METHODS
  HIV patients (n=120) on highly active antiretroviral therapy (HAART) in the infectious disease clinic of Hospital Sungai Buloh were randomized to either FDC (n=60) or FRC (n=60). Morisky scores, health-related quality of life scores and clinical outcomes such as CD4 count and viral load were assessed in both groups at baseline and six months.
  
  
  RESULTS
  Patients on FDC (108 SD=1.1) had a significantly higher CD4 count increase compared to the FRC group (746.1 SD=36.3 vs 799.8 SD=33.8) (p <0.001). The viral load profile was unchanged and remained undetectable in both groups. The quality of life EQ-5D scores showed a positive correlation with CD4 counts in the FDC group (ρ=0.301, p=0.019) at six months. On the other hand, quality of life EQ-VAS scores was significantly associated with medication adherence in the FDC group at six months (ρ=0.749, p=0.05). However, no significant changes or associations were observed in the FRC group.
  
  
  CONCLUSIONS
  Management of HAART using an FDC demonstrated a positive clinical outcome, adherence and quality of life within six months in local HIV patients.
authors.affiliation: Faculty of Pharmacy, National University of Malaysia . Kuala Lumpur ( Malaysia ). tineshwaranv@gmail.com.
authors.forename: Tineshwaran
authors.initials: T
authors.lastname: Velvanathan
authors.affiliation: Faculty of Pharmacy, National University of Malaysia . Kuala Lumpur ( Malaysia ). faridaislahudin@ukm.edu.my.
authors.forename: Farida
authors.initials: F
authors.lastname: Islahudin
authors.affiliation: Hospital Sungai Buloh. Sungai Buloh ( Malaysia ). limsim7@yahoo.com.
authors.forename: Benedict L
authors.initials: BL
authors.lastname: Sim
authors.affiliation: Faculty of Pharmacy, National University of Malaysia . Kuala Lumpur ( Malaysia ). nurakmar@ukm.edu.my.
authors.forename: Nur A
authors.initials: NA
authors.lastname: Taha
keywords: Anti-Retroviral Agents; Antiretroviral Therapy; Benzoxazines; CD4 Lymphocyte Count; Drug Combinations; Emtricitabine; Highly Active; Malaysia; Tenofovir; Viral Load