Clinical and Virologic Outcomes After Changes in First Antiretroviral Regimen at 7 Sites in the Caribbean, Central and South America Network

Simple item page
dc.contributor.authorWolff, Marcelo
dc.contributor.authorShepherd, Bryan
dc.contributor.authorCortes, Claudia
dc.contributor.authorRebeiro, Peter
dc.contributor.authorCesar, Carina
dc.contributor.authorWagner Cardoso, Sandra
dc.contributor.authorPape, Jean W
dc.contributor.authorPadgett, Denis
dc.contributor.authorSierra-Madero, Juan
dc.contributor.authorEchevarria, Juan
dc.contributor.authorMcGowan, Catherine C
dc.date.accessioned2024-05-23T23:48:59Z
dc.date.available2024-05-23T23:48:59Z
dc.date.issued2016-01-01
dc.descriptionFil: Cesar C. Fundación Huésped, Buenos Aires; Argentinaes_ES
dc.description.abstractBackground: HIV-infected persons in resource-limited settings may experience high rates of antiretroviral therapy (ART) change, particularly because of toxicity or other nonfailure reasons. Few reports address patient outcomes after these modifications. Methods: HIV-infected adults from the 7 Caribbean, Central and South America network clinical cohorts who modified >1 drug from the first ART regimen (ART-1) for any reason thereby starting a second regimen (ART-2) were included. We assessed cumulative incidence of, and factors associated with, death, virologic failure (VF), and regimen change after starting ART-2. Results: Five thousand five hundred sixty-five ART-naive highly active ART initiators started ART-2 after a median of 9.8 months on ART-1; 39% changed to ART-2 because of toxicity and 11% because of failure. Median follow-up after starting ART-2 was 2.9 years; 45% subsequently modified ART-2. Cumulative incidences of death at 1, 3, and 5 years after starting ART-2 were 5.1%, 8.4%, and 10.5%, respectively. In adjusted analyses, death was associated with older age, clinical AIDS, lower CD4 at ART-2 start, earlier calendar year, and starting ART-2 because of toxicity (adjusted hazard ratio = 1.5 vs. failure, 95% confidence interval: 1.0 to 2.1). Cumulative incidences of VF after 1, 3, and 5 years were 9%, 19%, and 25%. In adjusted analyses, VF was associated with younger age, earlier calendar year, lower CD4 at the start of ART-2, and starting ART-2 because of failure (adjusted hazard ratio = 2.1 vs. toxicity, 95% confidence interval: 1.5 to 2.8). Conclusions: Among patients modifying the first ART regimen, risks of subsequent modifications, mortality, and virologic failure were high. Access to improved antiretrovirals in the region is needed to improve initial treatment success.es_ES
dc.formatapplication/pdfes_ES
dc.identifier.doihttps://doi.org/10.1097/qai.0000000000000817
dc.identifier.urihttps://repositorio.huesped.org.ar/handle/123456789/1294
dc.languageENGes_ES
dc.provenancePublishedes_ES
dc.relation.ispartofseriesJAIDS Journal of Acquired Immune Deficiency Syndromes;2016 Jan 1;71(1):102-110
dc.rightsopenAccesses_ES
dc.subjectCaribbean Regiones_ES
dc.subjectAnti-Retroviral Agentses_ES
dc.subjectTreatment Failurees_ES
dc.subjectCohort Studieses_ES
dc.subjectLatin Americaes_ES
dc.titleClinical and Virologic Outcomes After Changes in First Antiretroviral Regimen at 7 Sites in the Caribbean, Central and South America Networkes_ES
dc.typeArticuloes_ES

Files

Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
10.1097QAI.0000000000000817.pdf
Size:
340.06 KB
Format:
Adobe Portable Document Format
Description:
10.1097QAI.0000000000000817_eng
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.71 KB
Format:
Plain Text
Description:
Download

Collections

Articulos científicos