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Please use this identifier to cite or link to this item: http://hdl.handle.net/1843/46469
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dc.creatorLetícia Penna Bragapt_BR
dc.creatorCássia Cristina Pinto Mendicinopt_BR
dc.creatorEdna Afonso Reispt_BR
dc.creatorRicardo Andrade Carmopt_BR
dc.creatorCristiane Aparecida Menezes de Páduapt_BR
dc.date.accessioned2022-10-20T22:22:08Z-
dc.date.available2022-10-20T22:22:08Z-
dc.date.issued2017-08-22-
dc.citation.issue33pt_BR
dc.citation.spage346pt_BR
dc.citation.epage346pt_BR
dc.identifier.doihttps://doi.org/10.1002/pds.4275pt_BR
dc.identifier.issn1099-1557pt_BR
dc.identifier.urihttp://hdl.handle.net/1843/46469-
dc.description.resumoBackground: 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.pt_BR
dc.format.mimetypepdfpt_BR
dc.languageengpt_BR
dc.publisherUniversidade Federal de Minas Geraispt_BR
dc.publisher.countryBrasilpt_BR
dc.publisher.departmentFAR - DEPARTAMENTO DE FARMÁCIA SOCIALpt_BR
dc.publisher.departmentICX - DEPARTAMENTO DE ESTATÍSTICApt_BR
dc.publisher.initialsUFMGpt_BR
dc.relation.ispartofInternational Conference on Pharmacoepidemiology & Therapeutic Risk Managementpt_BR
dc.rightsAcesso Abertopt_BR
dc.subjectHIVpt_BR
dc.subjectAIDSpt_BR
dc.subjectTerapia antirretroviralpt_BR
dc.subjectEstudos de coortept_BR
dc.subject.otherHIVpt_BR
dc.subject.otherAIDSpt_BR
dc.titleEffectiveness of second-line antiretroviral therapy: the impact of drug switchespt_BR
dc.typeArtigo de Eventopt_BR
dc.url.externahttps://onlinelibrary.wiley.com/doi/full/10.1002/pds.4275pt_BR
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