Review of the impact of NNRTI-based HIV treatment regimens on patient-reported disease burden.

While the burden of HIV disease is well documented, the value of non-nucleoside reverse transcriptase inhibitor (NNRTI)-based therapy regimens in reducing patient burden is not well understood. The purpose of this study was to examine patient-reported health among those receiving NNRTI-based regimens to understand their incremental value in reducing the burden of HIV. We conducted a structured literature review using PubMed to identify NNRTI trials utilizing validated patient-reported outcome (PRO) instruments during 2005–2011. The search strategy included a PubMed search to identify relevant studies based on disease, instrument, PRO, and NNRTI medication terms; and a manual search of bibliographies of identified papers. Data abstracted from each study included study type, treatment regimen(s), and PRO results. Of 11 trials identified, 8 (73%) reported significance of changes in a PRO over time and 10 (91%) reported significance of PRO changes between groups. Several domains were assessed, with significant findings (between or within groups) observed in: physical health/well-being (n= 5), emotional status/well-being (n= 2), symptoms (n= 2), anxiety (n= 2), gastrointestinal upset (n= 2), psychological health (n= 1), functional and global well-being (n= 1), fatigue/energy (n= 1), depression (n= 1), change in body appearance (n= 1), pain (n= 1), headache (n= 1), bad dreams/nightmares (n= 1), problems having sex (n= 1), and general health perception (n= 1). In conclusion, NNRTIs have been observed most frequently to improve patient-reported physical health and well-being. Treatments are needed that can also reduce patient burden in areas of emotional well-being, cognitive functioning, and overall symptom profile. [ABSTRACT FROM AUTHOR]