4CPS-093 Persistence of an antiretroviral therapy in human immunodeficiency virus patients in a tertiary level hospital

BackgroundThe guidelines of antiretroviral therapy (ART) for the human immunodeficiency virus (HIV) recommend starting with all the patients, regardless of the levels of CD4 lymphocytes and the symptomatology.PurposePersistence: time a patient remains with a treatment frome the beginning until the interruption, regardless of the reason. Aim of this research: comparison between the patients’ persistence who different ART.Material and methodsDescriptive, transversal and retrospective research that includes all the patients who have started an ART for HIV, 2013–10 October 2018, and who have suffered a change in the therapy.Variables: starting date, initial treatment, changing date and reason for the change. Analysis: SPSS Statistics.ResultsSix-hundred and sixteen patients have started ART and 186 (30.2%) of them have changed it.Fifty-one (27.4%) patients started ART with single tablet regimens (STRs), 40 (78.4%) started with Tenofovir/Emtricitabine (TDF o TAF/FTC) and 11 (21,6%) Abacavir/Lamivudine (ABC/3TC). Thirty-two 62.7%) were with an integrase inhibitor (INI) as a third drug, and 19 (37.3%) with no analogous (ITINN).One-hundred and thirty-five (72.6%) patients started with multiple tablet regimens (MTRs), 115 (85.2%) TDF/FTC and 16 (11.8%) ABC/3TC. Seventy-two (53.7%) were with protease inhibitor (IP) as a third drug, 34 (25.4%) ITINN and 28 (20.9%) INI.The median survival for STRs was 229 days (95% CI 146.0 to 311.9) and 164 for MTRs (95% CI 87.8 to 240.2), no statistically significant differences. Regarding the third drug, the median survival with INI was 103 days (95% CI 65.0 to 140.9), 241 days with IP (95% CI 162.1 to 319.9) and 265 days with ITINN (95% CI 162.1 to 367.9). Between INI-IP and INI-ITNN, there were statistically significant differences.One-hundred and five (56.5%) patients changed their treatment because of toxicity, 48 (25.8%) patients simplification, 19 (10.2%) patients virologic failure, seven (3.8%) patients due to interaction with their home treatment and seven (3.7%) other causes. One-hundred and five patients changed ART by toxicity (39 of them (37.1%) had as a third drug IP, 37 (35.2%) ITINN and 29 (27.6%) INI)In 2013–2015, 20 (16.8%) patients started STRs and in 2016–2018, 31 (46.3%) patients started STRs.ConclusionART combinations with STRs have a longer survival in the treatment and in patients with IP as a third drug, a greater survival is observed. The main cause of ART in naïve patients is toxicity. There was a gradual r