Background: Long-acting injectable formulations for HIV infection have been approved and are now available in Japan. Although not currently recommended as first-line drugs in Japanese or overseas guidelines, use of such formulations may increase, in accordance with patient conditions and preference. We determine the level of satisfaction with current anti-HIV drugs and analyzed the preferences of patients who favor long-acting injectable drugs based on their satisfaction level with the present anti-HIV drugs. Methods: People living with HIV (PLWH) who had received antiretroviral therapy (ART) for at least one month and consented to the study between 1 April and 31 December 2021 were included in a survey conducted using a self-administered questionnaire. The content of the survey included satisfaction with seven items (tablet size, ease and feeling when taking the medicine, color, taste, portability, daily oral therapy, and co-payment) related to the anti-HIV drugs they were taking and their need for future drugs (dosage form, frequency of dosing, long-acting injectable, etc.). In addition, factors related to the need for long-acting injectable medications were analyzed with regard to the relationship with satisfaction with anti-HIV drugs. Results: Overall, 667 patients available for analysis were included in this study. Satisfaction with anti-HIV drugs was highest with regard to "co-payment" and lowest with "daily oral therapy". Regarding the need for long-acting injectable medications, logistic regression analysis indicated that tablet size and daily oral therapy were significant predictors of patient preference for a once-every-eight-weeks intramuscular formulation in terms of their requirement for long-acting injectable medications (tablet size, OR=2.14, 95%CI 1.030-4.430, p=0.042; and daily oral therapy, OR=1.75, 95%CI 1.010-3.030, p=0.044). Conclusions: Patients currently receiving anti-HIV drugs who express dissatisfaction with tablet size and daily oral therapy may prefer a long-acting injectable formulation, taking into consideration patient age, employment status, ART history, frequency of daily dosage and concomitant medications other than ART.

Busulfex ® is a non-aqueous injection of insoluble Busulfan dissolved in the oil-based solvents Polyethylene Glycol 400 (PEG400) and N,N-Dimethylacetamide (DMA). The use of a closed system transfer device (CSTD) is strongly recommended for the preparation of all hazardous drugs, and we use a CSTD for the preparation and administration of anticancer drugs at Nara Medical University Hospital. We experienced a case of frequent blockage of the intravenous route when Busulfex ® was administered. In the present study, when the test solution containing PEG400 and DMA mixed in the same ratio as Busulfex ® was syringe aspirated by CSTD, the CSTD was broken and foreign particles were generated within 3 minutes of aspiration. When DMA was syringe aspirated by CSTD, polycarbonate, the material of CSTD, was eluted, and functional abnormality of CSTD was observed 30 minutes after aspiration. Oil-based solvents are used as additives in many anticancer drugs. The suitability of a CSTD for the preparation of anticancer drugs should be determined by considering not only the hazard classi cation of the anticancer drug, but also the type and ratio of the additives.

Pharmacists interventions are considered to be important at the time of starting anti-HIV therapy or changing treatment in outpatient care for HIV infection. We conducted a questionnaire survey to clarify patients assessments of pharmacists interventions in outpatient care for HIV infection. The survey was conducted at seven AIDS treatment center hospitals in the Kinki region, and the analysis was performed on 112 patients receiving the initial treatment and 79 patients experiencing treatment change. Pharmacists interventions were found to be helpful by 97.3 of the initial treatment patients and 96.2 of the treatment change patients; the former often found it helpful in understanding the necessity of receiving drugs and failure in taking drugs and acquisition of resistance , while the latter often found it helpful in understanding the difference of the new drug from the previous one and side effects. Pharmacists interventions relieved anxiety in 89.3 of the initial treatment patients and 89.9 of the treatment change patients, and produced good overall effects such as relieving anxiety as regards receiving drugs , facilitating communication with doctors , and reducing questions for doctors. The survey results showed that pharmacists interventions at the time of starting anti-HIV therapy or changing treatment met patients needs and contributed to improving the quality of medical care, such as reducing patient anxiety and the burden on doctors.