ArticleAIDS research and therapy2016
Factors associated with the first antiretroviral therapy modification in older HIV-1 positive patients.
Article in AIDS research and therapy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 14 citations in OpenAlex.
- Associations of menopausal age with virological outcomes and engagement in care among women living with HIV in the UK.HIV research & clinical practice · 2020Article
- Risk factors for kidney disease among HIV-1 positive persons in the methadone program.Clinical and experimental nephrology · 2019Article
- Virologic failure and mortality in older ART initiators in a multisite Latin American and Caribbean Cohort.Journal of the International AIDS Society · 2018Article
- Article
- Meeting the WHO 90% target: antiretroviral treatment efficacy in Poland is associated with baseline clinical patient characteristics.Journal of the International AIDS Society · 2017Article
- HIV drug therapy duration; a Swedish real world nationwide cohort study on InfCareHIV 2009-2014.PloS one · 2017Observational
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRates of first antiretroviral therapy (cART) modifications are high in most observational studies. The age-related differences in treatment duration and characteristics of first cART modifications remain underinvestigated. With increasing proportion of older patients in HIV population it is important to better understand age-related treatment effects.
methodsPatients were included into this analysis, if being cART naïve at the first visit at the clinic. Follow-up time was measured from the first visit date until first cART modification or 28 February 2013. First cART modification was defined as any change in the third drug component i.e. protease inhibitor (PI), non-nucleoside reverse transcriptase inhibitor (NNRTI), integrase inhibitor or fusion inhibitor. Cox proportional hazard models were used to identify factors related to first cART modification in three age groups: <30, 30-50 and >50.
resultsIn total 2027 patients with 14,965 person-years of follow-up (PYFU) were included. The oldest group included 136 patients with 1901, middle group 1202 with 8416 PYFU and youngest group consisted of 689 patients with 4648 PYFU. Median follow-up time was 5.8 (IQR 3.4-9.4) years, median time on first cART was 4.4 (IQR 2.1-8.5) years. 72.4 % of patients started PI-based and 26.1 % NNRTI-based regimen. In total 1268 (62.5 %) patients had cART modification (non-adherence 30.8 %, toxicity 29.6 %). Durability of first cART was the best in patients over 50 y.o. (log-rank test, p = 0.001). Factors associated with discontinuation in this group were late presentation (HR 0.45, [95 % CI 0.23-0.90], p = 0.02) and PI use (HR 2.17, [95 % CI 1.18-4.0], p = 0.01).
conclusionsRates of first cART modifications or discontinuation were comparable in all groups; however older patients were significantly longer on first cART regimen.
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