Comparative effectiveness of antiretroviral drug classes for the treatment of HIV infection in patients with high viral loads: a multicentre retrospective cohort study.

Autor: Adams JL; Philadelphia College of Pharmacy, University of the Sciences, Philadelphia, PA, USA.; Division of Infectious Diseases, Cooper University Hospital, Camden, NJ, USA., Murray M; Chicago College of Pharmacy, Midwestern University, Downers Grove, IL, USA.; Northwestern Memorial Hospital, Chicago, IL, USA., Patel N; Skaggs School of Pharmacy & Pharmaceutical Sciences, University of California San Diego, San Diego, CA, USA.; Albany Stratton VA Medical Center, Albany, NY, USA., Sawkin MT; KC CARE Health Center, Kansas City, MO, USA., Boardman RC; Philadelphia College of Pharmacy, University of the Sciences, Philadelphia, PA, USA., Pham C; Philadelphia College of Pharmacy, University of the Sciences, Philadelphia, PA, USA., Kaur H; Philadelphia College of Pharmacy, University of the Sciences, Philadelphia, PA, USA., Patel D; Philadelphia College of Pharmacy, University of the Sciences, Philadelphia, PA, USA., Yager JL; Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO, USA., Pontiggia L; Misher College of Arts and Sciences, University of the Sciences, Philadelphia, PA, USA., Baxter J; Division of Infectious Diseases, Cooper University Hospital, Camden, NJ, USA.; Cooper Medical School of Rowan University, Camden, NJ, USA.
Jazyk: angličtina
Zdroj: HIV medicine [HIV Med] 2021 Jan; Vol. 22 (1), pp. 28-36. Date of Electronic Publication: 2020 Sep 23.
DOI: 10.1111/hiv.12959
Abstrakt: Objectives: We aimed to compare the effectiveness of antiretroviral therapy (ART) classes for achieving HIV RNA suppression to < 50 HIV-1 RNA copies/mL within 6 months of initiation with high viral loads (VLs). Secondary objectives were to compare viral suppression (VS) at 12 weeks and 12 months, partial HIV RNA suppression to < 200 copies/mL, time to VS, time to rebound, and change in CD4 cell count.
Methods: This was a multicentre, retrospective, observational study. Adult patients were included if they initiated ART between January 2005 and December 2016 with a VL ≥ 100 000 copies/mL.
Results: There were 220 patients included in the study. The median VL was 252 919 [interquartile range (IQR) 149 472-500 000] copies/mL. Nonnucleoside reverse transcriptase inhibitor (NNRTI) recipients were more likely to achieve VS by 6 months compared to those initiating ART containing protease inhibitors (PIs) [75.4% vs. 44.1%, respectively; odds ratio (OR) 3.34; 95% confidence interval (CI) 1.62-6.90] or integrase strand transfer inhibitors (INSTIs) (75.4% vs. 55.8%, respectively; OR 2.40; 95% CI 1.03-5.58). VS at 12 weeks was more frequent with INSTI-containing regimens than with PIs (28.9% vs. 9.0%, respectively; OR 4.10; 95% CI 1.69-9.92). VS at 12 months did not significantly differ between treatment regimens. Median time to complete VS for INSTI, PI and NNRTI recipients was 22.3 (95% CI 13.4-33), 30.1 (95% CI 25-36) and 19.9 (95% CI 16-22.3) weeks, respectively. There were no significant differences in time to viral rebound or change in CD4 cell counts.
Conclusions: Patients with high VLs initiated on NNRTIs were more likely to achieve VS by 6 months on ART compared to INSTI and PI recipients.
(© 2020 British HIV Association.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje