Clinical impact of tropism testing in a real-life cohort of HIV infected patients: a retrospective observational study

Autor:	Agnès Meybeck, Olivier Robineau, Faiza Ajana, Laurence Bocket, Philippe Choisy, Michel Valette, Laurène Deconinck
Jazyk:	angličtina
Rok vydání:	2019
Předmět:	Adult Male 0301 basic medicine medicine.medical_specialty CCR5 receptor antagonists Anti-HIV Agents 030106 microbiology Practice studies HIV Infections lcsh:Infectious and parasitic diseases Maraviroc 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Pharmacotherapy Internal medicine medicine Humans lcsh:RC109-216 Treatment Failure 030212 general & internal medicine Medical prescription Adverse effect Tropism Viral tropism Retrospective Studies business.industry HIV Retrospective cohort study Middle Aged Treatment Outcome Infectious Diseases chemistry Cohort HIV-1 Tissue tropism Female business Real-life management Research Article
Zdroj:	BMC Infectious Diseases, Vol 19, Iss 1, Pp 1-8 (2019) BMC Infectious Diseases
ISSN:	1471-2334
DOI:	10.1186/s12879-019-4047-7
Popis:	Background The circumstances of prescription of tropism tests clinically relevant in treatment-experienced patients are unclear. Methods We performed a monocentric retrospective analysis of all tropism tests performed between 2006 and 2015 in HIV-infected patients on antiretroviral therapy (ART) without MVC. The motivation of tropism determination was collected. Factors associated with MVC prescription were determined using logistic regression analysis. Results Five hundred sixty-three tests were performed in experienced patients not receiving MVC. Reasons for tropism performance were: virological failure (44%), side effects or drug-interactions (37%), simplification or sparing strategies (11%), immunological failure (5%), and improvement of neurological diffusion (3%). MVC was prescribed in 110 cases (20%), though 366 tests (65%) revealed a tropism CCR5. MVC was more often prescribed before 2011 (OR 3.65, 95% CI 2.17–6.13) and in patients with multiple previous ART regimens (less than 4 ART regimens compare to more than 10 ART regimens (OR 0.34, 95% CI 0.15–0.74)). Conclusions In experienced patients not receiving MVC, tropism test prescription should be restricted to patients with virological failure and limited therapeutic options such as patients already treated with a wide range of ART regimens.
Databáze:	OpenAIRE
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