Effectiveness and risk factors for virological outcome of darunavir-based therapy for treatment-experienced HIV-infected patients.

Autor: Mata-Marín JA; Infectious Diseases Department, National Medical Center 'La Raza', IMSS, Mexico Distrito Federal, Mexico ; Seris y Jacarandas s/n, Colonia 'La Raza', Del Azcapotzalco, CP 02990 Ciudad de México D.F., Mexico., Huerta-García G; Pediatric Infectious Diseases Department, National Medical Center 'Siglo XXI', IMSS, Mexico Distrito Federal, Mexico., Domínguez-Hermosillo JC; Infectious Diseases Department, National Medical Center 'La Raza', IMSS, Mexico Distrito Federal, Mexico., Chavez-García M; Infectious Diseases Department, Third Level Hospital No. 25, IMSS, Monterrey, NL Mexico., Banda-Lara MI; AIDS Clinic, General Hospital No 2, IMSS, San Luis Potosí, S.L.P. Mexico., Nuñez-Rodríguez N; AIDS Clinic, General Hospital No-24, IMSS, Mexico Distrito Federal, Mexico., Cruz-Herrera JE; AIDS Clinic, General Hospital No.72, IMSS, Mexico Distrito Federal, Mexico., Sandoval-Ramírez JL; Infectious Diseases Department, National Medical Center 'La Raza', IMSS, Mexico Distrito Federal, Mexico., Martínez-Abarca I; AIDS Clinic, General Hospital No.72, IMSS, Mexico Distrito Federal, Mexico., Villagómez-Ruíz AF; AIDS Clinic, Regional Hospital No. 1, IMSS, Culiacán, Sinaloa Mexico., Manjarrez-Tellez B; Infectious Diseases Department, National Medical Center 'La Raza', IMSS, Mexico Distrito Federal, Mexico., Gaytán-Martínez J; Infectious Diseases Department, National Medical Center 'La Raza', IMSS, Mexico Distrito Federal, Mexico.
Jazyk: angličtina
Zdroj: AIDS research and therapy [AIDS Res Ther] 2015 Sep 24; Vol. 12, pp. 31. Date of Electronic Publication: 2015 Sep 24 (Print Publication: 2015).
DOI: 10.1186/s12981-015-0072-9
Abstrakt: Objective: We evaluated the effectiveness of darunavir (DRV) treatment plus an optimized background regimen in 120 HIV-1 treatment-experienced patients.
Design: Retrospective cohort, multicenter study.
Methods: Adults >16 years with virological treatment failure starting therapy with a DRV-containing regimen were included. Effectiveness was evaluated as the percentage of patients with an undetectable HIV-1 RNA viral load (<50 and <200 copies/mL) after 48 weeks, and changes in CD4+ cell counts. We evaluated the risk factors associated with treatment failure.
Results: Of the cohort, 83 % were men with a median age of 45 years (interquartile range, IQR 40-51). They had experienced treatment for a median of 13 years (IQR 9-17) with a median of six previous regimens (IQR 4-7), all using protease inhibitors. After treatment, 82 % (95 % confidence interval, CI 74-88 %) of patients had an HIV-1 RNA viral load <200 copies/mL and 69 % (95 % CI 60-76 %) had <50 copies/mL. The CD4+ cell count increased by 378 cells/μL (IQR 252-559; P < 0.001 vs. baseline). Risk factors associated with poor outcome were age >40 years [odds ratio, OR 0.15 (95 % CI 0.10-0.78); P = 0.015], use of raltegravir in the regimen [OR 0.37 (95 % CI 0.10-0.97); P = 0.046], and baseline CD4+ cell count <200 cells/μL [OR 2.79 (95 % CI 1.11-6.97); P = 0.028].
Conclusion: In this Mexican cohort Darunavir was metabolically safe, well tolerated and achieved high rates of virological suppression in highly treatment-experienced patients infected with HIV-1.
Databáze: MEDLINE
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