Effectiveness of second-line antiretroviral therapy
The impact of drug switches
Bibliographic Data
| ID | 19442126 |
|---|---|
| Authors | Letícia Penna Braga (0000-0001-9754-356X, Universidade Federal de Minas Gerais, corresponding author), Cássia C P Mendicino (0000-0002-1627-292X, Universidade Federal de Minas Gerais), Edna Afonso Reis (0000-0003-1465-9167, Universidade Federal de Minas Gerais), Ricardo Andrade Carmo (0000-0002-5553-4742, Municipal Health Division, Infectious Disease Reference Center, CTR/DIP Orestes Diniz, Federal University of Minas Gerais, Belo Horizonte, Brazil), Cristiane A Menezes De Pádua (0000-0001-7083-3188, Universidade Federal de Minas Gerais) |
| Year | 2017 |
| Volume | 29 |
| Issue | 12 |
| Pages | 1585-1588 |
| Publication date | 2017-12-02 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | AIDS Care (JOURNAL) |
| Journal identifiers | ISSN: 0954-0121 • E-ISSN: 1360-0451 |
| Publisher | Informa UK Limited (PUBLISHER • GB) |
| DOI | 10.1080/09540121.2017.1322680 |
| PMID | 28490196 |
| OpenAlex | W2613129941 |
| Language | EN |
| References cited | 7 |
Including antiretroviral drug switches as a measure of ART failure could be more suitable than conventional measures to evaluate health outcomes in "real-world" settings. This is part of a historical cohort of HIV-infected adults who initiated ART from 2001-2005, and were followed up for a maximum of five years in three HIV/AIDS centers in Belo Horizonte, Brazil. Follow-up information included data from 2001-2010. All patients switched from first-line ART were included. Second-line ART effectiveness was measured as the time-to-ART failure. Failure was defined simulating two scenarios: (1) Clinical, immunological and virological failure (scenario 1); and scenario 1 plus ART switches (scenario 2). Descriptive analysis, Kaplan-Meier curves, log-rank test, and Cox proportional hazards model were performed. We identified 119 eligible patients; most had protease inhibitor (PI)-based regimens prescribed as second-line. The incidence of failure was different for the two scenarios (29.4% vs. 54.6% for scenario 1 and 2, respectively; p < 0.001). The main identifiers of failure were increase in viral load (31.1%) for scenario 1 and ART switches (42.8%) for scenario 2. Median duration on second-line ART was 36.8 vs. 19.8 months for scenario 1 and 2, respectively. In the Cox analysis of scenario 2, increased risk was found for patients given PI-based second-line regimens (HR = 2.26; 95% CI: 1.09-3.17). There is a high incidence of ART failure associated with PI-based regimens when ART switches are considered as an indicator of failure. This demonstrates the impact of ART switches in representing lack of ART effectiveness
Antiretroviral therapy · Cohort · Proportional hazards model · Survival analysis · Viral load · HIV Research and Treatment · HIV/AIDS drug development and treatment · HIV/AIDS Research and Interventions · Mathematics · Medicine · Internal Medicine · Virology
| Citation velocity | historical |
|---|---|
| Highly cited | No |