Effectiveness of second-line antiretroviral therapy: the impact of drug switches
| dc.creator | Letícia Penna Braga | |
| dc.creator | Cássia Cristina Pinto Mendicino | |
| dc.creator | Edna Afonso Reis | |
| dc.creator | Ricardo Andrade Carmo | |
| dc.creator | Cristiane Aparecida Menezes de Pádua | |
| dc.date.accessioned | 2022-10-20T22:22:08Z | |
| dc.date.accessioned | 2025-09-09T00:00:46Z | |
| dc.date.available | 2022-10-20T22:22:08Z | |
| dc.date.issued | 2017-08-22 | |
| dc.format.mimetype | ||
| dc.identifier.doi | https://doi.org/10.1002/pds.4275 | |
| dc.identifier.issn | 1099-1557 | |
| dc.identifier.uri | https://hdl.handle.net/1843/46469 | |
| dc.language | eng | |
| dc.publisher | Universidade Federal de Minas Gerais | |
| dc.relation.ispartof | International Conference on Pharmacoepidemiology & Therapeutic Risk Management | |
| dc.rights | Acesso Aberto | |
| dc.subject | HIV | |
| dc.subject | AIDS | |
| dc.subject.other | HIV | |
| dc.subject.other | AIDS | |
| dc.subject.other | Terapia antirretroviral | |
| dc.subject.other | Estudos de coorte | |
| dc.title | Effectiveness of second-line antiretroviral therapy: the impact of drug switches | |
| dc.type | Artigo de evento | |
| local.citation.epage | 346 | |
| local.citation.issue | 33 | |
| local.citation.spage | 346 | |
| local.description.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. | |
| local.publisher.country | Brasil | |
| local.publisher.department | FAR - DEPARTAMENTO DE FARMÁCIA SOCIAL | |
| local.publisher.department | ICX - DEPARTAMENTO DE ESTATÍSTICA | |
| local.publisher.initials | UFMG | |
| local.url.externa | https://onlinelibrary.wiley.com/doi/full/10.1002/pds.4275 |