Magnitude and predictors of first-line antiretroviral therapy regimen change among HIV infected adults: A retrospective cross sectional study

Alema, Niguse Meles; Asgedom, Solomon Weldegebreal; Maru, Mahlet; Berihun, Beletu; Gebrehiwet, Teklu; Atey, Tesfay Mehari; Demsie, Desalegn Getnet; Bantie, Abere Tilahun; Yehualaw, Adane; Taferre, Chernet; Seid, Sofia Assen; Girma, Timsel; Allene, Mengesha Dessie; Mulugeta, Sintayehu

doi:10.1016/j.amsu.2022.104303

Cited by 4 publications

(6 citation statements)

References 32 publications

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“…The reasons for regimen changes varied, including ADRs, treatment failure, optimization of treatment protocols, polypharmacy or comorbidity, as well as personal reasons [ 38 ]. Similar to previous studies [ 19 , 37 , 38 ], ADRs were the main reason for regimen changes. Middle-aged and older participants had a higher frequency of regimen changes and ADRs.…”

Section: Discussionsupporting

confidence: 84%

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Treatment outcomes amongst older people with HIV infection receiving antiretroviral therapy

Li,

Zheng,

et al. 2024

Aids

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Objectives: There is conflicting data regarding the response of older people with HIV (PWH) to antiretroviral therapy (ART). The objective of this study was to evaluate the long-term immunological and virological responses, changes in regimen, and adverse drug reactions (ADRs) in older participants (50+ years) compared with younger (18–34 years) and middle-aged (35–49 years) PWH. Methods: A retrospective review of medical records was conducted on 1622 participants who received ART in Yunnan Province, China, from 2010 to 2019. The study compared CD4+ T-cell counts, CD4+/CD8+ ratio, and relative numbers between different groups using the Kruskal–Wallis test. Cox proportional hazards regression models were used to identify variables associated with the occurrence of immune reconstitution insufficiency. The rates of immune reconstitution, incidence of ADRs, and rates of treatment change were analyzed using the chi-squared test or Fisher's exact test. Results: Over 95% achieved viral load 200 copies/ml or less, with no age-related difference. However, older participants exhibited significantly lower CD4+ T-cell counts and CD4+/CD8+ recovery post-ART (P < 0.001), with only 32.21% achieving immune reconstitution (compared with young: 52.16%, middle-aged: 39.29%, P < 0.001) at the end of follow-up. Middle-aged and elderly participants changed ART regimens more because of ADRs, especially bone marrow suppression and renal dysfunction. Conclusion: Although the virological response was consistent across age groups, older individuals showed poorer immune responses and higher susceptibility to side effects. This underscores the need for tailored interventions and comprehensive management for older HIV patients.

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Section: Discussionsupporting

confidence: 84%

“…Furthermore, regimen changes and the emergence of ADRs were also examined. Regimen changes was defined as any alteration, switch, or discontinuation of at least one antiretroviral drug from the initial ART regimen [ 19 ].…”

Section: Methodsmentioning

confidence: 99%

Treatment outcomes amongst older people with HIV infection receiving antiretroviral therapy

Li,

Zheng,

et al. 2024

Aids

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“…Tis could be explained by the overlapping toxicities of anti-TB and ART drugs, which have been well documented, and even some literature delay the initiation of ART during the intensive phase of the TB treatment course. Tere is also the documented drug-to-drug reaction of the anti-TB and ART drugs [39,[46][47][48][49].…”

Section: Discussionmentioning

confidence: 99%

Incidence and Predictors of Severe Adverse Drug Reactions among Patients on Antiretroviral Drugs in Harari Regional State, Eastern Ethiopia

Anbessa,

Hawulte,

Dingeta

et al. 2024

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Background. The introduction of combination antiretroviral therapy improves the quality and longevity of people living with HIV/AIDS. However, adverse drug reactions associated with antiretroviral therapy compromise the resulting benefits and have been reported differently worldwide, including Ethiopia. Severe adverse drug reactions are one of the major public health concerns for the reason that they can potentially impede the benefit of antiretroviral therapy and put the patient’s survival at risk. Despite many successes achieved with the introduction of the combined antiretroviral therapy, the majority of the patients on antiretroviral therapy experience adverse drug reactions associated with the drugs. Consequently, little is known about the problem in the current study area. This is, therefore, to study incidence and predictors of severe adverse drug reactions among patients on antiretroviral drugs in the Harari region, Eastern Ethiopia. The aim of this study was to assess the incidence and predictors of severe adverse drug reactions among patients on antiretroviral therapy from February 25, 2022, to March 25, 2022, in the Harari region, Eastern Ethiopia. Methods. A hospital-based retrospective cohort study was conducted among 449 randomly selected medical records of people living with HIV on first-line antiretroviral therapy. Collected data were entered into EpiData version 3.1 and exported to STATA version 15 for analysis. Kaplan–Meier survival curve with log-rank test was used to compare survival curves for categorical independent variables. A p value ≤0.05 was declared as significant, and an adjusted hazard ratio was used to report the effect size using the multivariate Cox proportional hazard model. Result. The overall incidence density of the severe adverse reactions was 7.22 per 1000 months (95% CI: 5.5, 9.6). After adjusting for all potential confounders using multivariable Cox proportional hazard ratio, advanced clinical diseases (AHR = 3.44; 95% CI: 1.54, 7.65), HIV/tuberculosis confections (AHR = 2.38; 95% CI: 1.23, 4.62), and being female (AHR = 3.12; 95% CI: 1.57, 6.18) were significantly associated with the experience of severe adverse drug reactions. Conclusion. In this study, the incidence of severe adverse reactions was consistent with the previous studies, and advanced World Health Organization (WHO) clinical stage, HIV/TB confection, and being female were the independent predictors of the severe adverse drug reactions.

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“…Продолжительность измерялась от начала терапии до изменения схемы лечения, отмены, смерти или до 24 месяцев наблюдения. Среднее время до изменения терапии (СО) составило 10,93 (7,4) месяца. Причинами изменения терапии были токсичность (41,3%), развитие туберкулеза (30,7%), неэффективность (19,6%) и другие причины (8,4%).…”

Section: результаты исследованияunclassified

“…Известно, что продолжительность жизни людей, живущих с ВИЧ, значительно увеличилась благодаря комплексу мер по оказанию специализированной медицинской помощи и имеющимся лекарственным препаратам [2]. Несмотря на это, в популяции пациентов нередки случаи изменения и прерывания курса терапии по ряду причин, в том числе по причине отсутствия вирусологического ответа, нежелательных явлений или несоблюдения режима терапии [3][4][5][6][7][8][9]. Изменение или отмена терапии могут повлечь за собой неблагоприятные клинические исходы заболевания и увеличение прямых и непрямых расходов системы здравоохранения.…”

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Durability of first-line antiretroviral treatment in the Russian Federation: retrospective study

Sizova,

Plotnikova,

Shimonova

et al. 2023

jour

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Objective. To assess durability of antiretroviral therapy in first line in HIV-infected patients in real clinical practice in the Russian Federation and determine association between basic clinical and demographic characteristics and durability of treatment.Materials and methods. A non-interventional retrospective study was conducted collecting data from primary medical records of HIV-infected patients who signed informed consent form and had started antiretroviral therapy in first line. Patients were enrolled if the third component was a non-nucleoside reverse transcriptase inhibitor (NNRTI) or ritonavir boosted protease inhibitor (PI/r) plus two nucleoside reverse transcriptase inhibitors (NRTIs). Also, patients must have been followed up for at least 96 since start of treatment. Durability of therapy was retrospectively assessed at 48±8 and 96±8.Results. 536 patients were enrolled. Percentage of patients without change of therapy was approximately 76% and 60%, and the mean duration of therapy without changes was approximately 47 and 79 weeks at 48±8 and 96±8 weeks, correspondingly. Durability of treatment was not different for NNRTI+2NRTIs and PI/r+2NRTIs. Only age ≥ 40 years as a basic characteristic was associated with ART change prior to 96 weeks: OR=1.391, 95% CI 1.005-1.925.Conclusions. In real clinical practice in Russia, durability of first-line antiretroviral therapy corresponds published scientific data (in terms of percentage of patients without change of treatment and its duration without change). Durability of treatment and factors associated with its early switch or stop should be investigated in prospective studies further.

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Magnitude and predictors of first-line antiretroviral therapy regimen change among HIV infected adults: A retrospective cross sectional study

Cited by 4 publications

References 32 publications

Treatment outcomes amongst older people with HIV infection receiving antiretroviral therapy

Treatment outcomes amongst older people with HIV infection receiving antiretroviral therapy

Incidence and Predictors of Severe Adverse Drug Reactions among Patients on Antiretroviral Drugs in Harari Regional State, Eastern Ethiopia

Durability of first-line antiretroviral treatment in the Russian Federation: retrospective study

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