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Alejos, Belén; Suárez-García, Inés; Rava, Marta; Bautista-Hernández, Azucena; Gutierrez, Félix; Dalmau, David; Sagastagoitia, Iñigo; Rivero, Antonio; Moreno, Santiago; Jarrín, Inma; Moreno, Santiago; Jarrín, Inma; Dalmau, David; Navarro, Maria Luisa; González, Maria Isabel; Garcia, Federico; Poveda, Eva; Iribarren, Jose Antonio; Gutiérrez, Félix; Rubio, Rafael; Vidal, Francesc; Berenguer, Juan; González, Juan; Ángeles Muñoz-Fernández, M; [...]

Effectiveness and safety of first-line antiretroviral regimens in clinical practice: a multicentre cohort study

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  • Medientyp: E-Artikel
  • Titel: Effectiveness and safety of first-line antiretroviral regimens in clinical practice: a multicentre cohort study
  • Beteiligte: Alejos, Belén; Suárez-García, Inés; Rava, Marta; Bautista-Hernández, Azucena; Gutierrez, Félix; Dalmau, David; Sagastagoitia, Iñigo; Rivero, Antonio; Moreno, Santiago; Jarrín, Inma; Moreno, Santiago; Jarrín, Inma; Dalmau, David; Navarro, Maria Luisa; González, Maria Isabel; Garcia, Federico; Poveda, Eva; Iribarren, Jose Antonio; Gutiérrez, Félix; Rubio, Rafael; Vidal, Francesc; Berenguer, Juan; González, Juan; Ángeles Muñoz-Fernández, M; [...]
  • Erschienen: Oxford University Press (OUP), 2020
  • Erschienen in: Journal of Antimicrobial Chemotherapy
  • Sprache: Englisch
  • DOI: 10.1093/jac/dkaa246
  • ISSN: 0305-7453; 1460-2091
  • Schlagwörter: Infectious Diseases ; Pharmacology (medical) ; Pharmacology ; Microbiology (medical)
  • Entstehung:
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  • Beschreibung: <jats:title>Abstract</jats:title><jats:sec><jats:title>Objectives</jats:title><jats:p>We compared 48 week effectiveness and safety of first-line antiretroviral regimens.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We analysed HIV treatment-naive adults from the Cohort of the Spanish HIV/AIDS Research Network (CoRIS) starting the most commonly used antiretroviral regimens from 2014 to 2018. We used multivariable regression models to assess the impact of initial regimen on: (i) viral suppression (VS) (viral load &amp;lt;50 copies/mL); (ii) change in CD4 cell count; (iii) CD4/CD8 normalization (&amp;gt;0.4 and &amp;gt;1); (iv) CD4 percentage normalization (&amp;gt;29%); (v) multiple T-cell marker recovery (MTMR: CD4 &amp;gt; 500 cells/mm3 plus CD4 percentage &amp;gt;29% plus CD4/CD8 &amp;gt; 1); (vi) lipid, creatinine and transaminase changes; and (vii) discontinuations due to adverse events (AE).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Among 3945 individuals analysed, the most frequently prescribed regimens were ABC/3TC/DTG (34.0%), TAF/FTC/EVG/CBT (17.2%), TDF/FTC + DTG (11.9%), TDF/FTC/EVG/CBT (11.7%), TDF/FTC/RPV (11.5%), TDF/FTC + bDRV (8.3%) and TDF/FTC + RAL (5.3%). At 48 weeks, 89.7% of individuals achieved VS with no significant differences by initial regimen. CD4 mean increase was 257.8 (249.3; 266.2) cells/mm3, and it was lower with TAF/FTC/EVG/CBT and TDF/FTC/RPV compared with ABC/3TC/DTG. CD4 percentage normalization was less likely with TAF/FTC/EVG/CBT, and MTMR was less likely with TAF/FTC/EVG/CBT and TDF/FTC + RAL. The proportion of discontinuations due to AE was higher with TDF/FTC + bDRV (9.7%), followed by TDF/FTC/EVG/CBT (9.5%) and TDF/FTC + DTG (7.9%). Compared with ABC/3TC/DTG, cholesterol and LDL mean increases were higher with TAF/FTC/EVG/CBT and lower with TDF/FTC + DTG, TDF/FTC/RPV and TDF/FTC + RAL. Higher mean increases in triglycerides were significantly associated with TAF/FTC/EVG/CBT. Regimens containing DTG showed higher creatinine increases.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>The significantly greater immunological response and safety of some combinations may be useful for making decisions when initiating treatment.</jats:p></jats:sec>
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