ArticleBMC infectious diseases2012
Predictors of first-line antiretroviral therapy discontinuation due to drug-related adverse events in HIV-infected patients: a retrospective cohort study.
Article in BMC infectious diseases, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers.
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Who cites it
50 citing papers in PubMed.
- Prevalence, trend and risk factors for antiretroviral therapy discontinuation among HIV-infected adults in Ethiopia in 2003-2015.PloS one · 2017Trial
- Trial
- Clinical Characteristics, Healthcare Utilization, and Treatment Patterns Among People Living with HIV by Antiretroviral Therapy Use in the USA, 2021-2024.Infectious diseases and therapy · 2026Article
- Determinants and outcomes of adverse drug reactions among people living with HIV on antiretroviral therapy in Nigeria.BMC infectious diseases · 2026Article
- Differences between different antiretroviral therapy regimens switching patterns among people living with HIV.BMC public health · 2026Article
- Adherence and Cost-Utility Analysis of Antiretroviral Treatment in People Living with HIV in a Specialized Clinic in Mexico City.Pharmacy (Basel, Switzerland) · 2025Article
- Incidence of Adverse Drug Reactions Among HIV Patients on Antiretroviral Drugs in Ethiopia: A Systematic Review and Meta-Analysis.AIDS research and treatment · 2025Review
- Evaluation of Adverse Drug Events in Patients on Anti-Retroviral Therapy Regimen at Omdurman Voluntary Counselling and Testing and Anti-Retroviral Therapy Center in Sudan - A Cross-Sectional Study.HIV/AIDS (Auckland, N.Z.) · 2024Article
- Analysis of antiretroviral therapy switch rate and switching pattern for people living with HIV from a national database in Japan.Scientific reports · 2022Observational
- Switching from a Non-Protease inhibitor-Based Regimen To the Fixed Dose Combination of Darunavir/Cobicistat/Emtricitabine/Tenofovir Alafenamide in Clinical Practice.Drug design, development and therapy · 2022Article
- Trends and factors associated with modification or discontinuation of the initial antiretroviral regimen during the first year of treatment in the Turkish HIV-TR Cohort, 2011-2017.AIDS research and therapy · 2021Article
- Article
- Increased Virological Failure and Determinants Among HIV Patients on Highly Active Retroviral Therapy in Adigrat General Hospital, Northern Ethiopia, 2019: Hospital-Based Cross-Sectional Study.Infection and drug resistance · 2020Article
- HIV infection among men who have sex with men in Israel: a 35-year epidemiological and clinical overview, 1981-2015.BMC public health · 2019Review
- Switch rates, time-to-switch, and switch patterns of antiretroviral therapy in people living with human immunodeficiency virus in Japan, in a hospital-claim database.BMC infectious diseases · 2019Article
- Nature and prevalence of adverse drug reaction of antiretroviral medications in Halibet National Referral Hospital: a retrospective study.BMC pharmacology & toxicology · 2019Article
- Older HIV-infected adults. Complex patients (III): Polypharmacy.European geriatric medicine · 2019Article
- Social media as a tool to monitor adherence to HIV antiretroviral therapy.Journal of clinical and translational research · 2018Article
- Adverse Drug Reactions Among Patients Initiating Second-Line Antiretroviral Therapy in South Africa.Drug safety · 2018Article
- Adverse reactions associated with first-line regimens in patient initiating antiretroviral therapy.European journal of clinical pharmacology · 2018Article
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10 authors.
Funding
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Abstract
backgroundDrug-related toxicity has been one of the main causes of antiretroviral treatment discontinuation. However, its determinants are not fully understood. Aim of this study was to investigate predictors of first-line antiretroviral therapy discontinuation due to adverse events and their evolution in recent years.
methodsPatients starting first-line antiretroviral therapy were retrospectively selected. Primary end-point was the time to discontinuation of therapy due to adverse events, estimating incidence, fitting Kaplan-Meier and multivariable Cox regression models upon clinical/demographic/chemical baseline patients' markers.
results1,096 patients were included: 302 discontinuations for adverse events were observed over 1,861 person years of follow-up between 1988 and 2010, corresponding to an incidence (95% CI) of 0.16 (0.14-0.18). By Kaplan-Meier estimation, the probabilities (95% CI) of being free from an adverse event at 90 days, 180 days, one year, two years, and five years were 0.88 (0.86-0.90), 0.85 (0.83-0.87), 0.79 (0.76-0.81), 0.70 (0.67-0.74), 0.55 (0.50-0.61), respectively. The most represented adverse events were gastrointestinal symptoms (28.5%), hematological (13.2%) or metabolic (lipid and glucose metabolism, lipodystrophy) (11.3%) toxicities and hypersensitivity reactions (9.3%). Factors associated with an increased hazard of adverse events were: older age, CDC stage C, female gender, homo/bisexual risk group (vs. heterosexual), HBsAg-positivity. Among drugs, zidovudine, stavudine, zalcitabine, didanosine, full-dose ritonavir, indinavir but also efavirenz (actually recommended for first-line regimens) were associated to an increased hazard of toxicity. Moreover, patients infected by HIV genotype F1 showed a trend for a higher risk of adverse events.
conclusionsAfter starting antiretroviral therapy, the probability of remaining free from adverse events seems to decrease over time. Among drugs associated with increased toxicity, only one is currently recommended for first-line regimens but with improved drug formulation. Older age, CDC stage, MSM risk factor and gender are also associated with an increased hazard of toxicity and should be considered when designing a first-line regimen.
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