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http://hdl.handle.net/1843/46469| Tipo: | Artigo de Evento |
| Título: | Effectiveness of second-line antiretroviral therapy: the impact of drug switches |
| Autor(es): | Letícia Penna Braga Cássia Cristina Pinto Mendicino Edna Afonso Reis Ricardo Andrade Carmo Cristiane Aparecida Menezes de Pádua |
| Resumo: | Background: 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. Objectives: Evaluate the effectiveness of second-line ART in HIV-infected adults participating in a historical cohort study, comparing two scenarios by using different parameters to characterize ART failure. Methods: This is part of a historical cohort of HIV-infected adults who initiated ART from 2001 to 2005, and were followed up for a maximum of five years, conducted in three HIV/AIDS centers in Belo Horizonte, Brazil. Follow-up information included data from 2001 to 2010. All patients switched from first-line to second-line ART were included. Secondline ART effectiveness was measured as the timeto-ART failure. Failure was defined simulating to scenarios: (1) Clinical, immunological and virological failure (scenario 1); or scenario 1 plus ART switches (scenario 2). Descriptive analysis, Kaplan-Meier curves, log-rank test, and Cox proportional hazards model were performed. Results: A total of 119 patients were eligible; 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= 0.00). 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). Conclusions: 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. |
| Assunto: | HIV AIDS |
| Idioma: | eng |
| País: | Brasil |
| Editor: | Universidade Federal de Minas Gerais |
| Sigla da Instituição: | UFMG |
| Departamento: | FAR - DEPARTAMENTO DE FARMÁCIA SOCIAL ICX - DEPARTAMENTO DE ESTATÍSTICA |
| Tipo de Acesso: | Acesso Aberto |
| Identificador DOI: | https://doi.org/10.1002/pds.4275 |
| URI: | http://hdl.handle.net/1843/46469 |
| Data do documento: | 22-Ago-2017 |
| metadata.dc.url.externa: | https://onlinelibrary.wiley.com/doi/full/10.1002/pds.4275 |
| metadata.dc.relation.ispartof: | International Conference on Pharmacoepidemiology & Therapeutic Risk Management |
| Aparece nas coleções: | Artigo de Evento |
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| Arquivo | Descrição | Tamanho | Formato | |
|---|---|---|---|---|
| Effectiveness of second-line antiretroviral therapy the impact of drug switches.pdf | 68.59 kB | Adobe PDF | Visualizar/Abrir |
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