Insights into the reasons for discontinuation of the first highly active antiretroviral therapy (HAART) regimen in a cohort of antiretroviral naïve patients

Abstract

If the current HAART regimen caused no toxicity, less than 10% of naïve patients discontinue their first HAART regimen because of failure after 1 year from starting therapy.

Short-Term Discontinuation of HAART Regimens More Common in Vulnerable Patient Populations

“…The ICONA study demonstrated that 25% of participants discontinued a HAART regimen by 1 year due to toxicity. 7 In the current study, 1026 of 1852 (55%) regimens were discontinued by 1 year and nearly half of these regimen discontinuations (458 of 1026 regimens) were due to toxicity attributed to antiretroviral medications.…”

“…1,7,[9][10][11][12][13][14] The most frequently reported side effects are gastrointestinal, including nausea, vomiting, and diarrhea. The ICONA study demonstrated that 25% of participants discontinued a HAART regimen by 1 year due to toxicity.…”

“…Concern regarding drug toxicity affects not only adherence to HAART regimens in patients being treated, but also may prevent some patients from initiating treatment. Bassetti and colleagues found that among their patients re- [1][2][3][4][5][6][7][8][9][10][11][12] fusing treatment with HAART, 19% feared side effects and 18% thought that the treatment regimen was overly complicated. 9 Improving patient education regarding the benefits of viral suppression and potential drug side effects and suggesting methods to help adhere to antiretroviral regimens are potential means of increasing initiation and decreasing discontinuation rates.…”

“…[1][2][3][4][5][6] However, toxicity associated with many of the antiretroviral drugs often leads to discontinuation or changes in treatment and also limits patient adherence and, therefore, virologic effectiveness. [7][8][9] Several observational studies have shown that medication side effects are the most common cause of discontinuation of HAART regimens. 1,7,[9][10][11][12][13][14] Gastrointestinal (GI)-related side effects such as nausea, vomiting, and diarrhea have been among the most commonly reported medication toxicities leading to regimen discontinuation in numerous studies.…”

“…[7][8][9] Several observational studies have shown that medication side effects are the most common cause of discontinuation of HAART regimens. 1,7,[9][10][11][12][13][14] Gastrointestinal (GI)-related side effects such as nausea, vomiting, and diarrhea have been among the most commonly reported medication toxicities leading to regimen discontinuation in numerous studies. 1,7,12,13,15,16 Other studies have shown that certain patient characteristics such as race, gender, or socioeconomic status may predict higher rates of regimen discontinuation.…”