Clinical Outcomes of 2-Drug Regimens vs 3-Drug Regimens in Antiretroviral Treatment-Experienced People Living With Human Immunodeficiency Virus
Autor: | Felipe Rogatto, Lene Ryom, Christian Pradier, Anders Sönnerborg, Vincenzo Spagnuolo, Annegret Pelchen-Matthews, Jolie Hutchinson, Ferdinand W. N. M. Wit, Huldrych F. Günthard, Antonella Castagna, Jan-Christian Wasmuth, Michael Skoll, Alexandra U. Scherrer, Coca Valentina Necsoi, Vani Vannappagari, Nikoloz Chkhartishvili, Alexandra Calmy, Bastian Neesgaard, Claudine Duvivier, Lauren Greenberg, Natalia Bolokadze, Matthew Law, Lars Peters, Jennifer F Hoy, Alain Volny Anne, Antonella d'Arminio Monforte, José M. Miró, Margaret A. Johnson, Stéphane De Wit, Amanda Mocroft, Martin Gisinger, Cristina Mussini, Clara Lehmann, Jens D Lundgren, Christoph Stephan, Thérèse Staub, Josep M. Llibre, Colette Smith, Mark Bloch, Loveleen Bansi-Matharu, Heiner C. Bucher, Gilles Wandeler |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
0301 basic medicine
Microbiology (medical) antiretroviral treatment medicine.medical_specialty Anti-HIV Agents 030106 microbiology HIV Infections 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Acquired immunodeficiency syndrome (AIDS) Interquartile range Internal medicine medicine Humans 030212 general & internal medicine Online Only Articles business.industry 2-drug regimens Incidence (epidemiology) Lamivudine HIV dual therapy Raltegravir medicine.disease clinical outcomes Regimen Infectious Diseases chemistry Anti-Retroviral Agents Pharmaceutical Preparations Dolutegravir Cohort business medicine.drug |
Zdroj: | Greenberg, L, Ryom, L, Neesgaard, B, Wandeler, G, Staub, T, Gisinger, M, Skoll, M, Günthard, H F, Scherrer, A, Mussini, C, Smith, C, Johnson, M, De Wit, S, Necsoi, C, Pradier, C, Wit, F, Lehmann, C, d'Arminio Monforte, A, Miró, J M, Castagna, A, Spagnuolo, V, Sönnerborg, A, Law, M, Hutchinson, J, Chkhartishvili, N, Bolokadze, N, Wasmuth, J C, Stephan, C, Vannappagari, V, Rogatto, F, Llibre, J M, Duvivier, C, Hoy, J, Bloch, M, Bucher, H C, Calmy, A, Volny Anne, A, Pelchen-Matthews, A, Lundgren, J D, Peters, L, Bansi-Matharu, L, Mocroft, A & RESPOND (International Cohort Consortium of Infectious Diseases) Study Group 2021, ' Clinical Outcomes of 2-Drug Regimens vs 3-Drug Regimens in Antiretroviral Treatment-Experienced People Living With Human Immunodeficiency Virus ', Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, vol. 73, no. 7, pp. e2323-e2333 . https://doi.org/10.1093/cid/ciaa1878 Clin Infect Dis Clinical Infectious Diseases r-IGTP. Repositorio Institucional de Producción Científica del Instituto de Investigación Germans Trias i Pujol instname |
ISSN: | 1058-4838 |
DOI: | 10.1093/cid/ciaa1878 |
Popis: | Background Limited data exist that compare clinical outcomes of 2-drug regimens (2DRs) and 3-drug regimens (3DRs) in people living with human immunodeficiency virus. Methods Antiretroviral treatment–experienced individuals in the International Cohort Consortium of Infectious Diseases (RESPOND) who switched to a new 2DR or 3DR from 1 January 2012–1 October 2018 were included. The incidence of clinical events (AIDS, non-AIDS cancer, cardiovascular disease, end-stage liver and renal disease, death) was compared between regimens using Poisson regression. Results Of 9791 individuals included, 1088 (11.1%) started 2DRs and 8703 (88.9%) started 3DRs. The most common 2DRs were dolutegravir plus lamivudine (22.8%) and raltegravir plus boosted darunavir (19.8%); the most common 3DR was dolutegravir plus 2 nucleoside reverse transcriptase inhibitors (46.9%). Individuals on 2DRs were older (median, 52.6 years [interquartile range, 46.7–59.0] vs 47.7 [39.7–54.3]), and a higher proportion had ≥1 comorbidity (81.6% vs 73.9%). There were 619 events during 27 159 person-years of follow-up (PYFU): 540 (incidence rate [IR] 22.5/1000 PYFU; 95% confidence interval [CI]: 20.7–24.5) on 3DRs and 79 (30.9/1000 PYFU; 95% CI: 24.8–38.5) on 2DRs. The most common events were death (7.5/1000 PYFU; 95% CI: 6.5–8.6) and non-AIDS cancer (5.8/1000 PYFU; 95% CI: 4.9–6.8). After adjustment for baseline demographic and clinical characteristics, there was a similar incidence of events on both regimen types (2DRs vs 3DRs IR ratio, 0.92; 95% CI: .72–1.19; P = .53). Conclusions This is the first large, international cohort to assess clinical outcomes on 2DRs. After accounting for baseline characteristics, there was a similar incidence of events on 2DRs and 3DRs. 2DRs appear to be a viable treatment option with regard to clinical outcomes. Further research on resistance barriers and long-term durability of 2DRs is needed. |
Databáze: | OpenAIRE |
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