Determinants of Antiretroviral Treatment Success and Adherence in People With Human Immunodeficiency Virus Treated for Tuberculosis.

Autor: De Castro N; Bordeaux Population Health Centre, Research Institute for Sustainable Development (IRD) EMR 271, National Institute for Health and Medical Research (INSERM) UMR 1219, University of Bordeaux, Bordeaux, France.; Infectious Diseases Department, AP-HP-Hôpital Saint-Louis Lariboisière, Paris, France., Chazallon C; Bordeaux Population Health Centre, Research Institute for Sustainable Development (IRD) EMR 271, National Institute for Health and Medical Research (INSERM) UMR 1219, University of Bordeaux, Bordeaux, France., N'takpe JB; Bordeaux Population Health Centre, Research Institute for Sustainable Development (IRD) EMR 271, National Institute for Health and Medical Research (INSERM) UMR 1219, University of Bordeaux, Bordeaux, France.; Programme PACCI/ANRS Research Center, Abidjan, Côte-d'Ivoire., Timana I; Instituto Nacional de Saúde, Marracuene, Mozambique., Escada R; National Institute of Infectious Diseases Evandro Chagas, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil., Wagner S; National Institute of Infectious Diseases Evandro Chagas, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil., Messou E; Programme PACCI/ANRS Research Center, Abidjan, Côte-d'Ivoire.; Centre de Prise en Charge de Recherche et de Formation, CePReF-Aconda-VS, Abidjan, Côte-d'Ivoire., Eholie S; Programme PACCI/ANRS Research Center, Abidjan, Côte-d'Ivoire.; Département de Dermatologie et d'Infectiologie, UFR des Sciences Médicales, Université Félix Houphouët Boigny, Abidjan, Cote d'Ivoire., Bhatt N; Instituto Nacional de Saúde, Marracuene, Mozambique., Khosa C; Instituto Nacional de Saúde, Marracuene, Mozambique., Laureillard D; Department of Infectious and Tropical Diseases, Nimes University Hospital, Nimes, France.; Pathogenesis and Control of Chronic and Emerging Infections, INSERM UMR 1058, University of Montpellier, Montpellier, France., Do Chau G; Pham Ngoc Thach Hospital, Ho Chi Minh City, Vietnam., Veloso VG; Instituto Nacional de Saúde, Marracuene, Mozambique., Delaugerre C; Virology Department, APHP-Hôpital Saint-Louis, Paris.; INSERM U944, Paris.; Université de Paris., Anglaret X; Bordeaux Population Health Centre, Research Institute for Sustainable Development (IRD) EMR 271, National Institute for Health and Medical Research (INSERM) UMR 1219, University of Bordeaux, Bordeaux, France., Molina JM; Infectious Diseases Department, AP-HP-Hôpital Saint-Louis Lariboisière, Paris, France.; INSERM U944, Paris.; Université de Paris., Grinsztejn B; Instituto Nacional de Saúde, Marracuene, Mozambique., Marcy O; Bordeaux Population Health Centre, Research Institute for Sustainable Development (IRD) EMR 271, National Institute for Health and Medical Research (INSERM) UMR 1219, University of Bordeaux, Bordeaux, France.
Jazyk: angličtina
Zdroj: Open forum infectious diseases [Open Forum Infect Dis] 2022 Nov 19; Vol. 9 (12), pp. ofac628. Date of Electronic Publication: 2022 Nov 19 (Print Publication: 2022).
DOI: 10.1093/ofid/ofac628
Abstrakt: Background: In people with human immunodeficiency virus [HIV] presenting with advanced disease, rates of virologic success may be lower than expected. The Reflate TB2 trial did not show non-inferiority of raltegravir versus efavirenz in people with HIV (PWH) treated for tuberculosis. We aimed to identify factors associated with virologic success and higher adherence in the trial.
Methods: In this analysis, we included participants enrolled in the Reflate TB2 trial with adherence data available. The primary outcome was virologic success (HIV-1 ribonucleic acid [RNA] <50 copies/mL) at week 48, and the secondary outcome was adherence as assessed by the pill count adherence ratio. We used logistic regression to study determinants of virologic success and optimal adherence in 2 separate analyses.
Results: Four hundred forty-four participants were included in the present analysis. Over the 48-week follow-up period, 290 of 444 (65%) participants had a pill count adherence ratio ≥95%. At week 48, 288 of 444 (65%) participants were in virologic success. In the multivariate analysis, female sex (adjusted odds ratio [aOR], 1.77; 95% confidence interval [CI], 1.16-2.72; P = .0084), lower baseline HIV-1 RNA levels (<100 000; aOR, 2.29; 95% CI, 1.33-3.96; P = .0087), and pill count adherence ratio ≥95% (aOR, 2.38; 95% CI, 1.56-3.62; P < .0001) were independently associated with virologic success. Antiretroviral pill burden was the only factor associated with pill count adherence ratio ≥95% (OR, 0.81; 95% CI, .71-.92; P = .0018).
Conclusions: In PWH with tuberculosis receiving raltegravir or efavirenz-based regimens, female sex, optimal adherence, and baseline HIV-1 RNA <100 000 copies/mL were associated with virologic success, and the number of antiretroviral tablets taken daily was a strong predictor of adherence.
(© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
Databáze: MEDLINE
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