Heavily treatment-experienced persons living with HIV currently in care in Italy: characteristics, risk factors, and therapeutic options—the ICONA Foundation cohort study

Autor: Sergio Lo Caputo, Mariacristina Poliseno, Alessandro Tavelli, Roberta Gagliardini, Stefano Rusconi, Giuseppe Lapadula, Andrea Antinori, Daniela Francisci, Loredana Sarmati, Andrea Gori, Vincenzo Spagnuolo, Francesca Ceccherini-Silberstein, Antonella d'Arminio Monforte, Alessandro Cozzi-Lepri
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: International Journal of Infectious Diseases, Vol 143, Iss , Pp 106956- (2024)
Druh dokumentu: article
ISSN: 1201-9712
DOI: 10.1016/j.ijid.2024.01.023
Popis: Objectives: Heavily treatment-experienced (HTE) people living with HIV (PLWH) pose unique challenges due to limited antiretroviral treatment (ART) options. Our study aimed to investigate the prevalence and features of HTE individuals followed up in the Italian Cohort Naïve Antiretrovirals (ICONA) cohort as of December 31, 2021. Methods: HTE were defined based on meeting specific conditions concerning their current ART and their ART history up to December 31, 2021. Descriptive statistics were performed by HTE status. Regression analyses explored factors associated with becoming HTE based on pre-ART patients' characteristics. Cluster dendrogram analysis provided insights into subgroups with inadequate responses based on clusters of differentiation (CD4) counts and viral load (VL) trajectories. Results: Among the 8758 PLWH actively followed in our cohort, 163 individuals (1.9%), mainly female, younger, Italian, and infected through heterosexual contact, met the HTE criteria. A lower CD4 count at ART initiation (odds ratio [OR] 1.60 per 100 cells/mmc lower CD4, 95% confidence interval [CI] 1.06-2.41, P = 0.03) and hepatitis C virus antibody positivity (OR 1.90, 95% CI 1.16-3.11, P = 0.01) were associated with higher HTE risk. Thirty PLWH exhibited ongoing immune-virological failure (18% of the HTE subgroup and 0.003% of the total population). Thirty PLWH exhibited ongoing immune-virological failure (i.e., with a current CD4 count 200 copies/mL). A cluster analysis identified 13 (43%) with a current CD4 count
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