BACKGROUND: The HEARTS (HIV Epidemiology and AntiRetroviral Treatment Study) is a non-interventional retrospective claims database study of patients receiving healthcare services for their HIV infection between 2005 and 2015 in Hungary (n=1772), who were identified from the National Health Insurance Fund Administration databases based on multiple criteria including International Classification of Diseases and International Classification of Procedures in Medicine codes, and medication purchase data. The first results about the epidemiology of HIV patients was published earlier. During the entire period, a total of 1,496 (84.4%) of the prevalent patients received antiretroviral (ARV) treatment. OBJECTIVES: In this part of the study, our aim was to investigate the changes of ARV drug dispensing over time at active substance and drug class level, to determine the therapeutic adherence of patients and to examine the persistence of active substances as third agents of combination therapies, especially darunavir (DRV). METHODS: The method of the ARV drug utilization analysis is based on days of treatment estimation RESULTS: Between 2005 and 2015 the most commonly dispended protease inhibitors (PI) were ritonavir (alone or as pharmacokinetic booster) (35%) and DRV (28%), whilst the patients most often used lamivudine (62%), tenofovir (56%) and zidovidin+lamivudine (41%) as their dual nucleoside reverse transcriptase inhibitor (NRTI) backbone.The adherence of the treated prevalent population was fair (≥80%) as defined by the PDC (proportion of days covered) ratio. Considering the third agent consumption of the adherent patient population, amongst Pi's persistence of DRV was the highest. Assuming 60-day gaps, the 1-year and 5-year persistence was 87% and 51%, respectively, and the median was 1851 days. CONCLUSIONS: Due to the development of ARV therapies and understanding their mechanism of action and keeping in mind the perspective of patients, we conclude that the tolerability and simplification of treatment administration could be major aspects of treatment success in real-world settings.