Durability and outcome of initial antiretroviral treatments received during 2000--2005 by patients in the Swiss HIV Cohort Study.

Details

Ressource 1Download: serval:BIB_C3F7BBB5F713.P001 (1083.05 [Ko])
State: Public
Version: author
License: Not specified
It was possible to publish this article open access thanks to a Swiss National Licence with the publisher.
Serval ID
serval:BIB_C3F7BBB5F713
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Durability and outcome of initial antiretroviral treatments received during 2000--2005 by patients in the Swiss HIV Cohort Study.
Journal
Journal of Infectious Diseases
Author(s)
Vo T.T., Ledergerber B., Keiser O., Hirschel B., Furrer H., Battegay M., Cavassini M., Bernasconi E., Vernazza P., Weber R.
Working group(s)
Swiss HIV Cohort Study
Contributor(s)
Battegay M., Bernasconi E., Böni J., Bucher HC., Bürgisser P., Calmy A., Cattacin S., Cavassini M., Dubs R., Egger M., Elzi L., Erb P., Fischer M., Flepp M., Fontana A., Francioli P., Furrer H., Fux C., Gorgievski M., Günthard H., Hirsch H., Hirschel B., Hösli I., Kahlert Ch., Kaiser L., Karrer U., Kind C., Klimkait T., Ledergerber B., Martinetti G., Martinez B., Müller N., Nadal D., Opravil M., Paccaud F., Pantaleo G., Rauch A., Regenass S., Rickenbach M., Rudin C., Schmid P., Schultze D., Schüpbach J., Speck R., Taffé P., Tarr P., Telenti A., Trkola A., Vernazza P., Weber R., Yerly S.
ISSN
0022-1899 (Print)
ISSN-L
0022-1899
Publication state
Published
Issued date
06/2008
Peer-reviewed
Oui
Volume
197
Number
12
Pages
1685-1694
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
BACKGROUND: Little is known about time trends, predictors, and consequences of changes made to antiretroviral therapy (ART) regimens early after patients initially start treatment.
METHODS: We compared the incidence of, reasons for, and predictors of treatment change within 1 year after starting combination ART (cART), as well as virological and immunological outcomes at 1 year, among 1866 patients from the Swiss HIV Cohort Study who initiated cART during 2000--2001, 2002--2003, or 2004--2005.
RESULTS: The durability of initial regimens did not improve over time (P = .15): 48.8% of 625 patients during 2000--2001, 43.8% of 607 during 2002--2003, and 44.3% of 634 during 2004--2005 changed cART within 1 year; reasons for change included intolerance (51.1% of all patients), patient wish (15.4%), physician decision (14.8%), and virological failure (7.1%). An increased probability of treatment change was associated with larger CD4+ cell counts, larger human immunodeficiency virus type 1 (HIV-1) RNA loads, and receipt of regimens that contained stavudine or indinavir/ritonavir, but a decreased probability was associated with receipt of regimens that contained tenofovir. Treatment discontinuation was associated with larger CD4+ cell counts, current use of injection drugs, and receipt of regimens that contained nevirapine. One-year outcomes improved between 2000--2001 and 2004--2005: 84.5% and 92.7% of patients, respectively, reached HIV-1 RNA loads of <50 copies/mL and achieved median increases in CD4+ cell counts of 157.5 and 197.5 cells/microL, respectively (P < .001 for all comparisons).
CONCLUSIONS: Virological and immunological outcomes of initial treatments improved between 2000--2001 and 2004--2005, irrespective of uniformly high rates of early changes in treatment across the 3 study intervals.
Keywords
Adult, Anti-HIV Agents/administration & dosage, Anti-HIV Agents/therapeutic use, Cohort Studies, Drug Administration Schedule, Female, HIV Infections/complications, HIV Infections/drug therapy, Hepatitis B/complications, Hepatitis C/complications, Humans, Male, Middle Aged, Switzerland, Time Factors, Treatment Outcome
Pubmed
Web of science
Open Access
Yes
Create date
06/03/2009 11:08
Last modification date
25/09/2019 7:10
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