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? |
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| 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] |
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| Database: | Psychology and Behavioral Sciences Collection |
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