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L. Greenberg, L. Ryom, B. Neesgaard, G. Wandeler, T. Staub, M. Gisinger, Michael Skoll, H. Günthard, A. Scherrer, C. Mussini, Colette J. Smith, Margaret Johnson, S. De Wit, C. Necsoi, C. Pradier, F. Wit, Clara Lehmann, A. d’Arminio Monforte, J. M. Miró, A. Castagna, V. Spagnuolo, A. Sönnerborg, M. Law, Jolie Hutchinson, N. Chkhartishvili, N. Bolokadze, J. Wasmuth, C. Stephan, V. Vannappagari, F. Rogatto, J. Llibre, C. Duvivier, J. Hoy, M. Bloch, H. Bucher, A. Calmy, A. Volny Anne, A. Pelchen-Matthews, J. Lundgren, L. Peters, L. Bansi-Matharu, A. Mocroft, F. Wit, P. Reiss, M. Hillebregt, M. Law, K. Petoumenos, N. Rose, R. Zangerle, H. Appoyer, S. De Wit, M. Delforge, G. Wandeler, C. Stephan, M. Bucht, N. Chkhartishvili, O. Chokoshvili, A. d’Arminio Monforte, A. Rodanò, A. Tavelli, I. Fanti, C. Mussini, V. Borghi, C. Pradier, E. Fontas, K. Dollet, C. Caissotti, J. Casabona, J. M. Miró, J. Llibre, A. Riera, J. Reyes- Urueña, C. Smith, F. Lampe, A. Castagna, A. Lazzarin, A. Poli, A. Sönnerborg, K. Falconer, V. Svedhem, H. Günthard, B. Ledergerber, H. Bucher, A. Scherrer, J. Wasmuth, J. Vehreschild, G. Fätkenheuer, A. Mocroft, J. Rooney, F. Rogatto, V. Vannappagari, H. Garges, J. Lundgren, J. Kowalska, D. Raben, L. Ryom, J. Rockstroh, L. Peters, A. Volny Anne, N. Dedes, E. D. Williams, C. Necsoi, A. d’Arminio Monforte, A. Bruguera, R. Haubrich, B. Neesgaard, L. Greenberg, L. Bansi-Matharu, V. Svedhem-Johansson, K. Grabmeier-Pfistershammer, J. Hoy, M. Bloch, D. Braun, A. Calmy, G. Schüttfort, M. Youle, S. Zona, A. Antinori, N. Bolokadze, C. Schwarze-Zander, J. Wasmuth, C. Duvivier, G. Dragović, R. Rădoi, C. Oprea, M. Vasylyev, R. Matulionytė, V. Mulabdić, G. Marchetti, E. Kuzovatova, N. Coppola, J. Begovac, I. Aho, S. Martini, A. Harxhi, T. Wæhre, A. Pharris, A. Vassilenko, J. Bogner, A. Maagaard, E. Jabłonowska, D. Elbirt, G. Marrone, C. Leen, C. Wyen, M. Kundro, E. Dixon Williams, J. Gallant, D. Thorpe, H. Diaz Cuervo, A. Volny-Anne, L. Mendão, J. F. Larsen, M. L. Jakobsen, T. Bruun, A. Bojesen, E. V. Hansen, T. Elsing, D. Kristensen, S. Thomsen, T. Weide, A. Pelchen-Matthews, D. Byonanebye
14 23. 12. 2020.

Clinical outcomes of two-drug regimens vs. three-drug regimens in antiretroviral treatment-experienced people living with HIV.

BACKGROUND Limited data exist comparing clinical outcomes of two-drug regimens (2DRs) and three-drug regimens (3DRs) in people living with HIV. METHODS Antiretroviral treatment-experienced individuals in RESPOND switching to a new 2DR or 3DR from 1/1/12-1/10/18 were included. The incidence of clinical events (AIDS, non-AIDS cancer, cardiovascular disease, end-stage liver and renal disease, death) was compared between regimens using Poisson regression. RESULTS Of 9791 individuals included, 1088 (11.1%) started 2DRs and 8703 (88.9%) 3DRs. The most common 2DRs were dolutegravir plus lamivudine (22.8%) and raltegravir plus boosted darunavir (19.8%); the most common 3DR was dolutegravir plus 2 nucleoside reverse transcriptase inhibitors (46.9%). Individuals on 2DRs were older (median 52.6 years [interquartile range 46.7-59.0] vs 47.7 [39.7-54.3]), and a higher proportion had ≥1 comorbidity (81.6% vs 73.9%).There were 619 events during 27,159 person-years of follow-up (PYFU): 540 (incidence rate [IR] 22.5/1000 PYFU [95% CI 20.7-24.5]) on 3DRs, 79 (30.9/1000 PYFU [24.8-38.5]) on 2DRs. The most common events were death (7.5/1000 PYFU [95% CI 6.5-8.6]) and non-AIDS cancer (5.8/1000 PYFU [4.9-6.8]). After adjustment for baseline demographic and clinical characteristics, there was a similar incidence of events on both regimen types (2DRs vs 3DRs IR ratio: 0.92 [0.72-1.19]; p=0.53). CONCLUSIONS This is the first large, international cohort assessing clinical outcomes on 2DRs. After accounting for baseline characteristics, there was a similar incidence of events on 2DRs and 3DRs. 2DRs appear to be a viable treatment option with regard to clinical outcomes; further research on resistance barriers and long-term durability of 2DRs is needed.


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