Treatment Modification in Human Immunodeficiency Virus–Infected Individuals Starting Combination Antiretroviral Therapy Between 2005 and 2008

Abstract

Drug toxicity remains a frequent reason for treatment modification; however, it does not affect treatment success. Close monitoring and management of adverse effects and drug-drug interactions are crucial for the durability of CART.

Long-Term Efficacy and Safety of Atazanavir/Ritonavir Treatment in a Real-Life Cohort of Treatment-Experienced Patients with HIV Type 1 Infection

“…As noted in previous studies, 11,25 gender differences in discontinuation rate, but not in virologic failure rate, were also observed in the present study. Although further investigations are required to better characterize differences in discontinuation rates, factors such as pregnancy and differences in adherence 25,26 or safety profile 11,26 between sexes have been proposed as potential reasons to explain the increased rate of discontinuation observed in females.…”

“…6,7 ATV/r-based regimens were generally well tolerated with a favorable rate of discontinuation over time when compared with other cohort studies examining discontinuation rates with several different first-line ARV regimens. 11,12 For example, among the seven first-line ARV regimens compared in the Swiss HIV Cohort Study, treatment modification rates at 1 year were lowest for tenofovir-emtricitabine combined with ATV/r (24.1%) and highest for zidovudine-lamivudine combined with ritonavir-boosted lopinavir (70.7%). 11 These rates are consistent with the treatment discontinuation rate up to 1 year of 21.2% found in the current study, which notably evaluated a much larger number of treatment-experienced patients switched to ATV/r.…”

“…11,12 For example, among the seven first-line ARV regimens compared in the Swiss HIV Cohort Study, treatment modification rates at 1 year were lowest for tenofovir-emtricitabine combined with ATV/r (24.1%) and highest for zidovudine-lamivudine combined with ritonavir-boosted lopinavir (70.7%). 11 These rates are consistent with the treatment discontinuation rate up to 1 year of 21.2% found in the current study, which notably evaluated a much larger number of treatment-experienced patients switched to ATV/r. When examining longer-term data, the durability of second-line ATV/r-based regimens in the current study is consistent with findings from a comparative 5-year cohort study of persistence on first-line cART according to the third agent employed in which median persistence on therapy was greater for ATV/r (1,016 days) compared with efavirenz (974 days) or ritonavir-boosted lopinavir (382 days).…”

“…10 In clinical settings, ATV/r-based regimens are associated with sustained virologic suppression and favorable rates of treatment discontinuation when compared with other ARV regimens. [11][12][13][14] However, information about these long-term real-life outcomes is sparse in patients receiving ATV/r [11][12][13] and in patients receiving boosted PI-based therapy in general, 15 especially in the case of treatment-experienced patients. 16,17 Therefore, the aim of the current study was to evaluate the long-term outcomes of ATV/r-based regimens in a large sample of ARV-experienced patients in a real-life European clinical setting.…”

705 – Psychotropic drugs and HIV

“…Existem actualmente quatro grupos de anti-retrovirais: inibidores da protease (IP's), análogos não nucleósidos inibidores da transcriptase reversa (NNRTI's), análogos nucleósidos inibidores da transcriptase reversa (NRTI's) e inibidores da fusão 8 . A terapêutica anti-retrovírica é baseada na combinação destes, que internacionalmente ficou conhecida como highly active antiretroviral therapy (HAART) 9 . O impacto benéfico da terapêutica anti-retrovírica, evidenciou-se pelo decréscimo acentuado de mortes por SIDA registado 10 .…”