ArticleBMC infectious diseases2023
Heavily treatment-experienced people living with HIV in the OPERA® cohort: population characteristics and clinical outcomes.
Article in BMC infectious diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 22 citations in OpenAlex.
- Virologic Outcomes With Lenacapavir in People With Human Immunodeficiency Virus: A Multicenter Real-World Study.Open forum infectious diseases · 2026Trial
- Impact of Fostemsavir in Individuals with Multidrug-Resistant HIV-1, Stratified by Baseline Viral Load.Infectious diseases and therapy · 2026Article
- Optimizing Salvage ART: Real-World Outcomes of Doravirine Plus DTG or BIC in Heavily Treatment-Experienced Persons Living with HIV.Microorganisms · 2026Article
- All-Cause Mortality in People With Four-Class Drug-Resistant HIV: A Matched Cohort Analysis With Data From the PRESTIGIO Registry.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Treatment patterns, health care resource utilization, and costs of heavily treatment-experienced people with HIV in the United States.Journal of managed care & specialty pharmacy · 2025Article
- Teropavimab and zinlirvimab sensitivity in people living with multidrug-resistant HIV-1: data from the PRESTIGIO Registry.Microbiology spectrum · 2025Observational
- Switch from Ibalizumab to Lenacapavir in a Rescue Regimen for a Heavily Treatment-Experienced (HTE) Patient with Multidrug-Resistant (MDR) HIV-1 Infection.International journal of molecular sciences · 2025Article
- Article
- Durability and effectiveness of dual vs. triple therapy and tablet simplification in ART: findings from the Italian MOSAICO study.Frontiers in pharmacology · 2025Article
- Heavily treatment-experienced patients with HIV: are new mechanisms of action enough?The Journal of international medical research · 2024Review
- Long-term outcome in a person with pandrug-resistant HIV: the added value of a multidisciplinary approach.JAC-antimicrobial resistance · 2024Article
- Difficult-to-treat HIV in Sweden: a cross-sectional study.BMC infectious diseases · 2024Article
- Fostemsavir resistance in clinical context: a narrative review.Therapeutic advances in infectious diseaseReview
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMulti-class resistance, intolerance, and drug-drug interactions can result in unique antiretroviral (ART) combinations for heavily treatment-experienced (HTE) people living with HIV (PLWH). We aimed to compare clinical outcomes between HTE and non-HTE PLWH.
methodsEligible ART-experienced PLWH in care in the OPERA® Cohort were identified in a cross-sectional manner on December 31, 2016 and observed from the date of initiation of the ART regimen taken on December 31, 2016 until loss to follow up, death, study end (December 31, 2018), or becoming HTE (non-HTE group only). In the absence of resistance data, HTE was defined based on the ART regimens used (i.e., exposed to ≥ 3 core agent classes or regimen suggestive of HTE). Time to virologic undetectability, failure, and immunologic preservation were assessed using Kaplan-Meier methods; cumulative probabilities were compared between the two groups. Regimen changes, incident morbidities, and death were described.
resultsA total of 24,183 PLWH (2277 HTE PLWH, 21,906 non-HTE) were followed for a median of 28 months (IQR 21, 38). Viremic HTE PLWH (viral load [VL] ≥ 50 copies/mL) were less likely to achieve undetectability (VL < 50 copies/mL; 24-month cumulative probability: 80% [95% Confidence Interval 77-82]) than their non-HTE counterparts (85% [84-86]). No difference was observed in the probability of maintaining VLs < 200 copies/mL over the first 48 months after achieving suppression (< 50 copies/mL). HTE PLWH were less likely than non-HTE PLWH to maintain CD4 cell counts ≥ 200 cells/µL (24-month cumulative probability: 95% HTE [91-93]; 97% non-HTE [97-97]), and more likely to change regimens (45% HTE; 41% non-HTE). Incident non-AIDS defining event (ADE) morbidities were common in both populations, though more likely among HTE PLWH (45%) than non-HTE PLWH (35%). Incident ADE morbidities and deaths were uncommon among HTE (ADEs 5%; deaths 2%) and non-HTE (ADEs 2%; deaths 1%) PLWH.
conclusionsHTE PLWH were at greater risk of unfavorable treatment outcomes than non-HTE PLWH, suggesting additional therapeutic options are needed for this vulnerable population.
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