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Incidences and risk factors of first-line HAART discontinuation: a limitation to the success of the “seek, test, treat, and retain” strategy?

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Title: Incidences and risk factors of first-line HAART discontinuation: a limitation to the success of the “seek, test, treat, and retain” strategy?
Authors: Keita, Momory (AUTHOR), Perbost, Isabelle (AUTHOR), Pugliese-Wehrlen, Sylvia (AUTHOR), Abel, Sylvie (AUTHOR), Pugliese, Pascal (AUTHOR), Enel, Patricia (AUTHOR), Cuzin, Lise (AUTHOR), Lang, Thierry (AUTHOR), Delpierre, Cyrille (AUTHOR)
Source: AIDS Care. Aug2014, Vol. 26 Issue 8, p1058-1069. 12p.
Subjects: HIV infection risk factors, HIV infection epidemiology, Confidence intervals, HIV infections, Longitudinal method, Multivariate analysis, Regression analysis, Research funding, Viral load, Body mass index, Highly active antiretroviral therapy, Disease incidence, Proportional hazards models, Data analysis software, Descriptive statistics, CD4 lymphocyte count
Abstract: To evaluate the incidence and risk factors of first-highly active antiretroviral therapy (HAART) modifications/interruptions and their causes in a cohort of newly-treated patients by using a competing risk model. In nine centers of the French cohort Dat'AIDS, in 1 year and 2 years of censorship, a competing risk analysis was implemented in HIV1 patients aged 18 years or older first-treated between September 2002 and March 2012. In 4669 patients, 3628 modifications (77.7%) were observed (median: 13.5 months). Cumulative incidence in 1 year: 46.8% [45.4–48.3]; in 2 years: 65.3% [63.8–66.8].Intolerance(n= 1167; 32.3%): in 1 year, except first-treated from 2002 to 2005, modifications were not different: 2002–2003 (24.6%) 2004–2005 (26.1%), 2006–2007 (19.4%), 2008–2009 (18.8%) and 2010-2011 (15.7%). Women, AIDS patients, and those aged 50 years and older had an excess risk.Therapeutic simplification(n= 1037; 28.6%): in 1 year, except first-treated from 2002 to 2003, modifications were not different: 2002–2003 (9.0%), 2004–2005 (16.0%), 2006–2007 (11.0%), 2008–2009 (15.7%) and 2010–2011 (10.0%). Conversely to injecting-drug-users and AIDS patients, women and first-treated with non-nucleosides had an excess risk.Therapeutic failure(n= 189; 5.2%): contrary to first-treated between 2002 and 2003 or 2008 and 2009, in 1 year as in 2 years, modifications were not different. In 1 year, 1.9% for 2004–2005, 1.6% for 2006–2007 and 1.2% for 2010–2011. Maximum viral load ?5.0 log10copies/ml and CD4 <200 cells/mm3had a high probability. The study of first-HAART modifications suggests that in 1-year follow-up, intolerance incidence in the recent calendar year is still as frequent as the previous period which may constitute a limitation to the success of the seek, test, treat, and retain. [ABSTRACT FROM PUBLISHER]
Copyright of AIDS Care is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Incidences and risk factors of first-line HAART discontinuation: a limitation to the success of the “seek, test, treat, and retain” strategy?
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22AIDS+Care%22&quot;&gt;AIDS Care&lt;/searchLink&gt;. Aug2014, Vol. 26 Issue 8, p1058-1069. 12p.
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  Data: To evaluate the incidence and risk factors of first-highly active antiretroviral therapy (HAART) modifications/interruptions and their causes in a cohort of newly-treated patients by using a competing risk model. In nine centers of the French cohort Dat&#39;AIDS, in 1 year and 2 years of censorship, a competing risk analysis was implemented in HIV1 patients aged 18 years or older first-treated between September 2002 and March 2012. In 4669 patients, 3628 modifications (77.7%) were observed (median: 13.5 months). Cumulative incidence in 1 year: 46.8% [45.4–48.3]; in 2 years: 65.3% [63.8–66.8].Intolerance(n= 1167; 32.3%): in 1 year, except first-treated from 2002 to 2005, modifications were not different: 2002–2003 (24.6%) 2004–2005 (26.1%), 2006–2007 (19.4%), 2008–2009 (18.8%) and 2010-2011 (15.7%). Women, AIDS patients, and those aged 50 years and older had an excess risk.Therapeutic simplification(n= 1037; 28.6%): in 1 year, except first-treated from 2002 to 2003, modifications were not different: 2002–2003 (9.0%), 2004–2005 (16.0%), 2006–2007 (11.0%), 2008–2009 (15.7%) and 2010–2011 (10.0%). Conversely to injecting-drug-users and AIDS patients, women and first-treated with non-nucleosides had an excess risk.Therapeutic failure(n= 189; 5.2%): contrary to first-treated between 2002 and 2003 or 2008 and 2009, in 1 year as in 2 years, modifications were not different. In 1 year, 1.9% for 2004–2005, 1.6% for 2006–2007 and 1.2% for 2010–2011. Maximum viral load ?5.0 log10copies/ml and CD4 &lt;200 cells/mm3had a high probability. The study of first-HAART modifications suggests that in 1-year follow-up, intolerance incidence in the recent calendar year is still as frequent as the previous period which may constitute a limitation to the success of the seek, test, treat, and retain. [ABSTRACT FROM PUBLISHER]
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  Data: &lt;i&gt;Copyright of AIDS Care is the property of Taylor &amp; Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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        Value: 10.1080/09540121.2014.882490
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      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 12
        StartPage: 1058
    Subjects:
      – SubjectFull: HIV infection risk factors
        Type: general
      – SubjectFull: HIV infection epidemiology
        Type: general
      – SubjectFull: Confidence intervals
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      – SubjectFull: HIV infections
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      – SubjectFull: Longitudinal method
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      – SubjectFull: Regression analysis
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      – SubjectFull: Research funding
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      – SubjectFull: Viral load
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      – SubjectFull: Body mass index
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      – SubjectFull: Highly active antiretroviral therapy
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      – SubjectFull: CD4 lymphocyte count
        Type: general
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      – TitleFull: Incidences and risk factors of first-line HAART discontinuation: a limitation to the success of the “seek, test, treat, and retain” strategy?
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              Text: Aug2014
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