Antiretroviral treatment indications and adherence to the German-Austrian treatment initiation guidelines in the German ClinSurv HIV Cohort between 1999 and 2016

Stecher, Melanie; Schommers, Philipp; Schmidt, Daniel; Kollan, Christian; Gunsenheimer‐Bartmeyer, Barbara; Lehmann, Clara; Platten, Martin; Fätkenheuer, Gerd; Vehreschild, Jörg Janne

doi:10.1007/s15010-018-1248-8

Cited by 10 publications

(5 citation statements)

References 24 publications

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“…Once-daily regimens, especially those with an STR, showed a better durability of the first-line treatment, as also shown in other studies [4,10,24,25]. This effect is most likely due to the potentially improved adherence that is seen with these treatment regimens [26] and also due to the lack of further optimization options.…”

Section: Discussionsupporting

confidence: 66%

Treatment modification after starting cART in people living with HIV: retrospective analysis of the German ClinSurv HIV Cohort 2005–2017

et al. 2020

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Objective Combination antiretroviral therapy (cART) has markedly increased survival and quality of life in people living with HIV. With the advent of new treatment options, including single-tablet regimens, durability and efficacy of first-line cART regimens are evolving. Methods We analyzed data from the prospective multicenter German Clinical Surveillance of HIV Disease (ClinSurv) cohort of the Robert-Koch Institute. Kaplan–Meier and Cox proportional hazards models were run to examine the factors associated with treatment modification. Recovery after treatment initiation was analyzed comparing pre-cART viral load and CD4+ T-cell counts with follow-up data. Results We included 8788 patients who initiated cART between 2005 and 2017. The sample population was predominantly male (n = 7040; 80.1%), of whom 4470 (63.5%) were reporting sex with men as the transmission risk factor. Overall, 4210 (47.9%) patients modified their first-line cART after a median time of 63 months (IQR 59–66). Regimens containing integrase strand transfer inhibitors (INSTI) were associated with significantly lower rates of treatment modification (adjusted hazard ratio 0.44; 95% CI 0.39–0.50) compared to protease inhibitor (PI)-based regimens. We found a decreased durability of first-line cART significantly associated with being female, a low CD4+ T-cell count, cART initiation in the later period (2011–2017), being on a multi-tablet regimen (MTR). Conclusions Drug class and MTRs are significantly associated with treatment modification. INSTI-based regimens showed to be superior compared to PI-based regimens in terms of durability.

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Section: Discussionsupporting

confidence: 66%

Treatment modification after starting cART in people living with HIV: retrospective analysis of the German ClinSurv HIV Cohort 2005–2017

et al. 2020

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“…We have identified 4/33 patients who acquired SARS-CoV-2, while these patients were treated with a PI containing regimen, consisting in boosted darunavir in all cases. This percentage does not appear to differ markedly from the total PLWH population in Germany, in which the proportion of patients on boosted PIs has constantly decreased during recent years [20,21]. For another HIV-PI, lopinavir, uncontrolled studies have indicated a potential benefit in COVID-19 with early initiation [22][23][24].…”

Section: Discussionmentioning

confidence: 80%

COVID-19 in people living with human immunodeficiency virus: a case series of 33 patients

et al. 2020

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Introduction Data on people living with human immunodeficiency virus (PLWH) in the current SARS-CoV-2 pandemic are still scarce. This case series of 33 PLWH patients with COVID-19 reveals symptoms and outcome in this special population. Methods Retrospective analysis of anonymized data including age, gender, HIV-associated parameters, symptoms, and outcome. Results Three out of 32 patients with documented outcomes died (9%). 91% of the patients recovered and 76% have been classified as mild cases. All patients were on antiretroviral treatment, of them 22 on tenofovir-containing regimen and 4 on the protease inhibitor darunavir. Conclusions This preliminary case series does not support excess morbidity and mortality among symptomatic COVID-19 PLWH and with viral suppression on ART. SARS-CoV-2 infections may occur during boosted darunavir-based and/or on tenofovir-containing ART.

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“…We have identified 4/33 patients who acquired SARS-CoV-2 while these patients were treated with a PI containing regimen, consisting in boosted darunavir in all cases. This percentage does not appear to differ markedly from the total PLWH population in Germany, in which the proportion of patients on boosted PIs has constantly decreased during recent years [20, 21]. For another HIV-PI, lopinavir, uncontrolled studies have indicated a potential benefit in COVID-19 with early initiation [22–24].…”

Section: Discussionmentioning

confidence: 99%

COVID-19 in people living with human immunodeficiency virus: A case series of 33 patients

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et al. 2020

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Data on people living with human immunodeficiency virus (PLWH) in the current SARS-CoV-2 pandemic is still scarce. This case series of 33 PLWH patients with COVID-19 reveals symptoms and outcome in this special population. Three out of 32 patients with documented outcome died (9%). However, 91% of the patients recovered and 76% have been classified as mild cases, indicating that there is no excess morbidity and mortality among PLWH with symptomatic COVID-19. All patients were on antiretroviral treatment, of them 22 on tenofovir-containing regimen, and 4 on the protease inhibitor darunavir.

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Antiretroviral treatment indications and adherence to the German-Austrian treatment initiation guidelines in the German ClinSurv HIV Cohort between 1999 and 2016

Cited by 10 publications

References 24 publications

Treatment modification after starting cART in people living with HIV: retrospective analysis of the German ClinSurv HIV Cohort 2005–2017

Treatment modification after starting cART in people living with HIV: retrospective analysis of the German ClinSurv HIV Cohort 2005–2017

COVID-19 in people living with human immunodeficiency virus: a case series of 33 patients

COVID-19 in people living with human immunodeficiency virus: A case series of 33 patients

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