Treatment outcomes of integrase inhibitors, boosted protease inhibitors and nonnucleoside reverse transcriptase inhibitors in antiretroviral‐naïve persons starting treatment
Objectives Although outcomes of antiretroviral therapy (ART) have been evaluated in randomized controlled trials, experiences from subpopulations defined by age, CD4 count or viral load (VL) in heterogeneous real‐world settings are limited. Methods The study design was an international multicohort c...
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| Veröffentlicht in: | HIV MEDICINE 2020-10, Vol.21 (9), p.599-606 |
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| creator | Mocroft, A Neesgard, B Zangerle, R Rieger, A Castagna, A Spagnuolo, V Antinori, A Lampe, FC Youle, M Vehreschild, JJ Mussini, C Borghi, V Begovac, J Duvivier, C Gunthard, HF Rauch, A Tiraboschi, J Chkhartishvili, N Bolokadze, N Wit, F Wasmuth, JC De Wit, S Necsoi, C Pradier, C Svedhem, V Stephan, C Petoumenos, K Garges, H Rogatto, F Peters, L Ryom, L |
| description | Objectives
Although outcomes of antiretroviral therapy (ART) have been evaluated in randomized controlled trials, experiences from subpopulations defined by age, CD4 count or viral load (VL) in heterogeneous real‐world settings are limited.
Methods
The study design was an international multicohort collaboration. Logistic regression was used to compare virological and immunological outcomes at 12 ± 3 months after starting ART with an integrase strand transfer inhibitor (INSTI), contemporary nonnucleoside reverse transcriptase inhibitor (NNRTI) or boosted protease inhibitor (PI/b) with two nucleos(t)ides after 1 January 2012. The composite treatment outcome (cTO) defined success as VL 750 cells/μL or a 33% increase where the baseline CD4 count was ≥ 500 cells/μL. Poisson regression compared clinical failures (AIDS/death ≥ 14 days after starting ART). Interactions between ART class and age, CD4 count, and VL were determined for each endpoint.
Results
Of 5198 ART‐naïve persons in the International Cohort Consortium of Infectious Diseases (RESPOND), 45.4% started INSTIs, 26.0% PI/b and 28.7% NNRTIs; 880 (17.4%) were aged > 50 years, 2539 (49.4%) had CD4 counts 100 000 copies/mL. Differences in virological and immunological success and clinical failure among ART classes were similar across age groups (≤ 40, 40–50 and > 50 years), CD4 count categories (≤ 350 vs. > 350 cells/μL) and VL categories at ART initiation (≤ 100 000 vs. > 100 000 copies/mL), with all investigated interactions being nonsignificant (P > 0.05).
Conclusions
Differences among ART classes in virological, immunological and clinical outcomes in ART‐naïve participants were consistent irrespective of age, immune suppression or VL at ART initiation. While confounding by indication cannot be excluded, this provides reassuring evidence that such subpopulations will equally benefit from contemporary ART. |
| doi_str_mv | 10.1111/hiv.12888 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_470181</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2444218153</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4268-d7db013cf0c4cfb86b9f894e2fa63ce635a6b704ec07aa978e0d584345a991623</originalsourceid><addsrcrecordid>eNp10U1u1jAQBuAIgWgpLLgAssQGJNL6L4mzrCpKK1ViU9hajjNpXRI72M5XdccRuEm5AzfhJAzNRyUq4Y1HzjOvHE9RvGR0n-E6uHSbfcaVUo-KXSZrVTLeisd3tSx5XfOd4llKV5SyRrT0abEjeKVUW6nd4sd5BJMn8JmEJdswQSJhIM5nuIgmAVaXrnM5xPSOdCGkDD2ZY8jw70difE988H6xI4TkeiARNhAR5Wh8stHN-UGL89iVXYQcw8ZFM_769t2bn7cbIDN2Bp9IyiZm5y8wZHvN58WTwYwJXmz3veLT8fvzo5Py7OOH06PDs9JKji_QN31HmbADtdIOnaq7dlCtBD6YWlioRWXqrqESLG2MaRsFtK-UFLIybctqLvaKcs1N1zAvnZ6jm0y80cE4vT36ghVo2VCmGPo3q8fH-bpAynpyycI4Gg9hSZpLVBytRPr6Ab0KS_T4N6ik5AgrgertqmwMKUUY7q_AqP4zdo1j13djR_tqm7h0E_T38u-cERys4NqNcPP_JH1y-nmN_A2UXL9c</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2444218153</pqid></control><display><type>article</type><title>Treatment outcomes of integrase inhibitors, boosted protease inhibitors and nonnucleoside reverse transcriptase inhibitors in antiretroviral‐naïve persons starting treatment</title><source>Wiley Free Content</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>SWEPUB Freely available online</source><creator>Mocroft, A ; Neesgard, B ; Zangerle, R ; Rieger, A ; Castagna, A ; Spagnuolo, V ; Antinori, A ; Lampe, FC ; Youle, M ; Vehreschild, JJ ; Mussini, C ; Borghi, V ; Begovac, J ; Duvivier, C ; Gunthard, HF ; Rauch, A ; Tiraboschi, J ; Chkhartishvili, N ; Bolokadze, N ; Wit, F ; Wasmuth, JC ; De Wit, S ; Necsoi, C ; Pradier, C ; Svedhem, V ; Stephan, C ; Petoumenos, K ; Garges, H ; Rogatto, F ; Peters, L ; Ryom, L</creator><creatorcontrib>Mocroft, A ; Neesgard, B ; Zangerle, R ; Rieger, A ; Castagna, A ; Spagnuolo, V ; Antinori, A ; Lampe, FC ; Youle, M ; Vehreschild, JJ ; Mussini, C ; Borghi, V ; Begovac, J ; Duvivier, C ; Gunthard, HF ; Rauch, A ; Tiraboschi, J ; Chkhartishvili, N ; Bolokadze, N ; Wit, F ; Wasmuth, JC ; De Wit, S ; Necsoi, C ; Pradier, C ; Svedhem, V ; Stephan, C ; Petoumenos, K ; Garges, H ; Rogatto, F ; Peters, L ; Ryom, L ; RESPOND study group ; the RESPOND study group</creatorcontrib><description>Objectives
Although outcomes of antiretroviral therapy (ART) have been evaluated in randomized controlled trials, experiences from subpopulations defined by age, CD4 count or viral load (VL) in heterogeneous real‐world settings are limited.
Methods
The study design was an international multicohort collaboration. Logistic regression was used to compare virological and immunological outcomes at 12 ± 3 months after starting ART with an integrase strand transfer inhibitor (INSTI), contemporary nonnucleoside reverse transcriptase inhibitor (NNRTI) or boosted protease inhibitor (PI/b) with two nucleos(t)ides after 1 January 2012. The composite treatment outcome (cTO) defined success as VL < 200 HIV‐1 RNA copies/mL with no regimen change and no AIDS/death events. Immunological success was defined as a CD4 count > 750 cells/μL or a 33% increase where the baseline CD4 count was ≥ 500 cells/μL. Poisson regression compared clinical failures (AIDS/death ≥ 14 days after starting ART). Interactions between ART class and age, CD4 count, and VL were determined for each endpoint.
Results
Of 5198 ART‐naïve persons in the International Cohort Consortium of Infectious Diseases (RESPOND), 45.4% started INSTIs, 26.0% PI/b and 28.7% NNRTIs; 880 (17.4%) were aged > 50 years, 2539 (49.4%) had CD4 counts < 350 cells/μL and 1891 (36.8%) had VL > 100 000 copies/mL. Differences in virological and immunological success and clinical failure among ART classes were similar across age groups (≤ 40, 40–50 and > 50 years), CD4 count categories (≤ 350 vs. > 350 cells/μL) and VL categories at ART initiation (≤ 100 000 vs. > 100 000 copies/mL), with all investigated interactions being nonsignificant (P > 0.05).
Conclusions
Differences among ART classes in virological, immunological and clinical outcomes in ART‐naïve participants were consistent irrespective of age, immune suppression or VL at ART initiation. While confounding by indication cannot be excluded, this provides reassuring evidence that such subpopulations will equally benefit from contemporary ART.</description><identifier>ISSN: 1464-2662</identifier><identifier>EISSN: 1468-1293</identifier><identifier>DOI: 10.1111/hiv.12888</identifier><identifier>PMID: 32588958</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Acquired immune deficiency syndrome ; Age ; AIDS ; Antiretroviral agents ; antiretroviral naïve ; Antiretroviral therapy ; CD4 antigen ; Clinical trials ; Consortia ; Health services ; HIV ; Human immunodeficiency virus ; Immunology ; Infectious diseases ; Integrase ; integrase inhibitors ; Non-nucleoside reverse transcriptase inhibitors ; nonnucleoside reverse transcriptase inhibitors ; Protease ; Protease inhibitors ; Proteinase inhibitors ; Ribonucleic acid ; RNA ; RNA-directed DNA polymerase ; Subpopulations ; Success</subject><ispartof>HIV MEDICINE, 2020-10, Vol.21 (9), p.599-606</ispartof><rights>2020 The Authors. published by John Wiley & Sons Ltd on behalf of British HIV Association</rights><rights>2020 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.</rights><rights>2020. This article is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4268-d7db013cf0c4cfb86b9f894e2fa63ce635a6b704ec07aa978e0d584345a991623</citedby><cites>FETCH-LOGICAL-c4268-d7db013cf0c4cfb86b9f894e2fa63ce635a6b704ec07aa978e0d584345a991623</cites><orcidid>0000-0001-8316-1122</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fhiv.12888$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fhiv.12888$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,314,550,776,780,881,1411,1427,27903,27904,45552,45553,46386,46810</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32588958$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:144051300$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Mocroft, A</creatorcontrib><creatorcontrib>Neesgard, B</creatorcontrib><creatorcontrib>Zangerle, R</creatorcontrib><creatorcontrib>Rieger, A</creatorcontrib><creatorcontrib>Castagna, A</creatorcontrib><creatorcontrib>Spagnuolo, V</creatorcontrib><creatorcontrib>Antinori, A</creatorcontrib><creatorcontrib>Lampe, FC</creatorcontrib><creatorcontrib>Youle, M</creatorcontrib><creatorcontrib>Vehreschild, JJ</creatorcontrib><creatorcontrib>Mussini, C</creatorcontrib><creatorcontrib>Borghi, V</creatorcontrib><creatorcontrib>Begovac, J</creatorcontrib><creatorcontrib>Duvivier, C</creatorcontrib><creatorcontrib>Gunthard, HF</creatorcontrib><creatorcontrib>Rauch, A</creatorcontrib><creatorcontrib>Tiraboschi, J</creatorcontrib><creatorcontrib>Chkhartishvili, N</creatorcontrib><creatorcontrib>Bolokadze, N</creatorcontrib><creatorcontrib>Wit, F</creatorcontrib><creatorcontrib>Wasmuth, JC</creatorcontrib><creatorcontrib>De Wit, S</creatorcontrib><creatorcontrib>Necsoi, C</creatorcontrib><creatorcontrib>Pradier, C</creatorcontrib><creatorcontrib>Svedhem, V</creatorcontrib><creatorcontrib>Stephan, C</creatorcontrib><creatorcontrib>Petoumenos, K</creatorcontrib><creatorcontrib>Garges, H</creatorcontrib><creatorcontrib>Rogatto, F</creatorcontrib><creatorcontrib>Peters, L</creatorcontrib><creatorcontrib>Ryom, L</creatorcontrib><creatorcontrib>RESPOND study group</creatorcontrib><creatorcontrib>the RESPOND study group</creatorcontrib><title>Treatment outcomes of integrase inhibitors, boosted protease inhibitors and nonnucleoside reverse transcriptase inhibitors in antiretroviral‐naïve persons starting treatment</title><title>HIV MEDICINE</title><addtitle>HIV Med</addtitle><description>Objectives
Although outcomes of antiretroviral therapy (ART) have been evaluated in randomized controlled trials, experiences from subpopulations defined by age, CD4 count or viral load (VL) in heterogeneous real‐world settings are limited.
Methods
The study design was an international multicohort collaboration. Logistic regression was used to compare virological and immunological outcomes at 12 ± 3 months after starting ART with an integrase strand transfer inhibitor (INSTI), contemporary nonnucleoside reverse transcriptase inhibitor (NNRTI) or boosted protease inhibitor (PI/b) with two nucleos(t)ides after 1 January 2012. The composite treatment outcome (cTO) defined success as VL < 200 HIV‐1 RNA copies/mL with no regimen change and no AIDS/death events. Immunological success was defined as a CD4 count > 750 cells/μL or a 33% increase where the baseline CD4 count was ≥ 500 cells/μL. Poisson regression compared clinical failures (AIDS/death ≥ 14 days after starting ART). Interactions between ART class and age, CD4 count, and VL were determined for each endpoint.
Results
Of 5198 ART‐naïve persons in the International Cohort Consortium of Infectious Diseases (RESPOND), 45.4% started INSTIs, 26.0% PI/b and 28.7% NNRTIs; 880 (17.4%) were aged > 50 years, 2539 (49.4%) had CD4 counts < 350 cells/μL and 1891 (36.8%) had VL > 100 000 copies/mL. Differences in virological and immunological success and clinical failure among ART classes were similar across age groups (≤ 40, 40–50 and > 50 years), CD4 count categories (≤ 350 vs. > 350 cells/μL) and VL categories at ART initiation (≤ 100 000 vs. > 100 000 copies/mL), with all investigated interactions being nonsignificant (P > 0.05).
Conclusions
Differences among ART classes in virological, immunological and clinical outcomes in ART‐naïve participants were consistent irrespective of age, immune suppression or VL at ART initiation. While confounding by indication cannot be excluded, this provides reassuring evidence that such subpopulations will equally benefit from contemporary ART.</description><subject>Acquired immune deficiency syndrome</subject><subject>Age</subject><subject>AIDS</subject><subject>Antiretroviral agents</subject><subject>antiretroviral naïve</subject><subject>Antiretroviral therapy</subject><subject>CD4 antigen</subject><subject>Clinical trials</subject><subject>Consortia</subject><subject>Health services</subject><subject>HIV</subject><subject>Human immunodeficiency virus</subject><subject>Immunology</subject><subject>Infectious diseases</subject><subject>Integrase</subject><subject>integrase inhibitors</subject><subject>Non-nucleoside reverse transcriptase inhibitors</subject><subject>nonnucleoside reverse transcriptase inhibitors</subject><subject>Protease</subject><subject>Protease inhibitors</subject><subject>Proteinase inhibitors</subject><subject>Ribonucleic acid</subject><subject>RNA</subject><subject>RNA-directed DNA polymerase</subject><subject>Subpopulations</subject><subject>Success</subject><issn>1464-2662</issn><issn>1468-1293</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>D8T</sourceid><recordid>eNp10U1u1jAQBuAIgWgpLLgAssQGJNL6L4mzrCpKK1ViU9hajjNpXRI72M5XdccRuEm5AzfhJAzNRyUq4Y1HzjOvHE9RvGR0n-E6uHSbfcaVUo-KXSZrVTLeisd3tSx5XfOd4llKV5SyRrT0abEjeKVUW6nd4sd5BJMn8JmEJdswQSJhIM5nuIgmAVaXrnM5xPSOdCGkDD2ZY8jw70difE988H6xI4TkeiARNhAR5Wh8stHN-UGL89iVXYQcw8ZFM_769t2bn7cbIDN2Bp9IyiZm5y8wZHvN58WTwYwJXmz3veLT8fvzo5Py7OOH06PDs9JKji_QN31HmbADtdIOnaq7dlCtBD6YWlioRWXqrqESLG2MaRsFtK-UFLIybctqLvaKcs1N1zAvnZ6jm0y80cE4vT36ghVo2VCmGPo3q8fH-bpAynpyycI4Gg9hSZpLVBytRPr6Ab0KS_T4N6ik5AgrgertqmwMKUUY7q_AqP4zdo1j13djR_tqm7h0E_T38u-cERys4NqNcPP_JH1y-nmN_A2UXL9c</recordid><startdate>202010</startdate><enddate>202010</enddate><creator>Mocroft, A</creator><creator>Neesgard, B</creator><creator>Zangerle, R</creator><creator>Rieger, A</creator><creator>Castagna, A</creator><creator>Spagnuolo, V</creator><creator>Antinori, A</creator><creator>Lampe, FC</creator><creator>Youle, M</creator><creator>Vehreschild, JJ</creator><creator>Mussini, C</creator><creator>Borghi, V</creator><creator>Begovac, J</creator><creator>Duvivier, C</creator><creator>Gunthard, HF</creator><creator>Rauch, A</creator><creator>Tiraboschi, J</creator><creator>Chkhartishvili, N</creator><creator>Bolokadze, N</creator><creator>Wit, F</creator><creator>Wasmuth, JC</creator><creator>De Wit, S</creator><creator>Necsoi, C</creator><creator>Pradier, C</creator><creator>Svedhem, V</creator><creator>Stephan, C</creator><creator>Petoumenos, K</creator><creator>Garges, H</creator><creator>Rogatto, F</creator><creator>Peters, L</creator><creator>Ryom, L</creator><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>7X8</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>ZZAVC</scope><orcidid>https://orcid.org/0000-0001-8316-1122</orcidid></search><sort><creationdate>202010</creationdate><title>Treatment outcomes of integrase inhibitors, boosted protease inhibitors and nonnucleoside reverse transcriptase inhibitors in antiretroviral‐naïve persons starting treatment</title><author>Mocroft, A ; Neesgard, B ; Zangerle, R ; Rieger, A ; Castagna, A ; Spagnuolo, V ; Antinori, A ; Lampe, FC ; Youle, M ; Vehreschild, JJ ; Mussini, C ; Borghi, V ; Begovac, J ; Duvivier, C ; Gunthard, HF ; Rauch, A ; Tiraboschi, J ; Chkhartishvili, N ; Bolokadze, N ; Wit, F ; Wasmuth, JC ; De Wit, S ; Necsoi, C ; Pradier, C ; Svedhem, V ; Stephan, C ; Petoumenos, K ; Garges, H ; Rogatto, F ; Peters, L ; Ryom, L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4268-d7db013cf0c4cfb86b9f894e2fa63ce635a6b704ec07aa978e0d584345a991623</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Acquired immune deficiency syndrome</topic><topic>Age</topic><topic>AIDS</topic><topic>Antiretroviral agents</topic><topic>antiretroviral naïve</topic><topic>Antiretroviral therapy</topic><topic>CD4 antigen</topic><topic>Clinical trials</topic><topic>Consortia</topic><topic>Health services</topic><topic>HIV</topic><topic>Human immunodeficiency virus</topic><topic>Immunology</topic><topic>Infectious diseases</topic><topic>Integrase</topic><topic>integrase inhibitors</topic><topic>Non-nucleoside reverse transcriptase inhibitors</topic><topic>nonnucleoside reverse transcriptase inhibitors</topic><topic>Protease</topic><topic>Protease inhibitors</topic><topic>Proteinase inhibitors</topic><topic>Ribonucleic acid</topic><topic>RNA</topic><topic>RNA-directed DNA polymerase</topic><topic>Subpopulations</topic><topic>Success</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mocroft, A</creatorcontrib><creatorcontrib>Neesgard, B</creatorcontrib><creatorcontrib>Zangerle, R</creatorcontrib><creatorcontrib>Rieger, A</creatorcontrib><creatorcontrib>Castagna, A</creatorcontrib><creatorcontrib>Spagnuolo, V</creatorcontrib><creatorcontrib>Antinori, A</creatorcontrib><creatorcontrib>Lampe, FC</creatorcontrib><creatorcontrib>Youle, M</creatorcontrib><creatorcontrib>Vehreschild, JJ</creatorcontrib><creatorcontrib>Mussini, C</creatorcontrib><creatorcontrib>Borghi, V</creatorcontrib><creatorcontrib>Begovac, J</creatorcontrib><creatorcontrib>Duvivier, C</creatorcontrib><creatorcontrib>Gunthard, HF</creatorcontrib><creatorcontrib>Rauch, A</creatorcontrib><creatorcontrib>Tiraboschi, J</creatorcontrib><creatorcontrib>Chkhartishvili, N</creatorcontrib><creatorcontrib>Bolokadze, N</creatorcontrib><creatorcontrib>Wit, F</creatorcontrib><creatorcontrib>Wasmuth, JC</creatorcontrib><creatorcontrib>De Wit, S</creatorcontrib><creatorcontrib>Necsoi, C</creatorcontrib><creatorcontrib>Pradier, C</creatorcontrib><creatorcontrib>Svedhem, V</creatorcontrib><creatorcontrib>Stephan, C</creatorcontrib><creatorcontrib>Petoumenos, K</creatorcontrib><creatorcontrib>Garges, H</creatorcontrib><creatorcontrib>Rogatto, F</creatorcontrib><creatorcontrib>Peters, L</creatorcontrib><creatorcontrib>Ryom, L</creatorcontrib><creatorcontrib>RESPOND study group</creatorcontrib><creatorcontrib>the RESPOND study group</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SwePub Articles full text</collection><jtitle>HIV MEDICINE</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mocroft, A</au><au>Neesgard, B</au><au>Zangerle, R</au><au>Rieger, A</au><au>Castagna, A</au><au>Spagnuolo, V</au><au>Antinori, A</au><au>Lampe, FC</au><au>Youle, M</au><au>Vehreschild, JJ</au><au>Mussini, C</au><au>Borghi, V</au><au>Begovac, J</au><au>Duvivier, C</au><au>Gunthard, HF</au><au>Rauch, A</au><au>Tiraboschi, J</au><au>Chkhartishvili, N</au><au>Bolokadze, N</au><au>Wit, F</au><au>Wasmuth, JC</au><au>De Wit, S</au><au>Necsoi, C</au><au>Pradier, C</au><au>Svedhem, V</au><au>Stephan, C</au><au>Petoumenos, K</au><au>Garges, H</au><au>Rogatto, F</au><au>Peters, L</au><au>Ryom, L</au><aucorp>RESPOND study group</aucorp><aucorp>the RESPOND study group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment outcomes of integrase inhibitors, boosted protease inhibitors and nonnucleoside reverse transcriptase inhibitors in antiretroviral‐naïve persons starting treatment</atitle><jtitle>HIV MEDICINE</jtitle><addtitle>HIV Med</addtitle><date>2020-10</date><risdate>2020</risdate><volume>21</volume><issue>9</issue><spage>599</spage><epage>606</epage><pages>599-606</pages><issn>1464-2662</issn><eissn>1468-1293</eissn><abstract>Objectives
Although outcomes of antiretroviral therapy (ART) have been evaluated in randomized controlled trials, experiences from subpopulations defined by age, CD4 count or viral load (VL) in heterogeneous real‐world settings are limited.
Methods
The study design was an international multicohort collaboration. Logistic regression was used to compare virological and immunological outcomes at 12 ± 3 months after starting ART with an integrase strand transfer inhibitor (INSTI), contemporary nonnucleoside reverse transcriptase inhibitor (NNRTI) or boosted protease inhibitor (PI/b) with two nucleos(t)ides after 1 January 2012. The composite treatment outcome (cTO) defined success as VL < 200 HIV‐1 RNA copies/mL with no regimen change and no AIDS/death events. Immunological success was defined as a CD4 count > 750 cells/μL or a 33% increase where the baseline CD4 count was ≥ 500 cells/μL. Poisson regression compared clinical failures (AIDS/death ≥ 14 days after starting ART). Interactions between ART class and age, CD4 count, and VL were determined for each endpoint.
Results
Of 5198 ART‐naïve persons in the International Cohort Consortium of Infectious Diseases (RESPOND), 45.4% started INSTIs, 26.0% PI/b and 28.7% NNRTIs; 880 (17.4%) were aged > 50 years, 2539 (49.4%) had CD4 counts < 350 cells/μL and 1891 (36.8%) had VL > 100 000 copies/mL. Differences in virological and immunological success and clinical failure among ART classes were similar across age groups (≤ 40, 40–50 and > 50 years), CD4 count categories (≤ 350 vs. > 350 cells/μL) and VL categories at ART initiation (≤ 100 000 vs. > 100 000 copies/mL), with all investigated interactions being nonsignificant (P > 0.05).
Conclusions
Differences among ART classes in virological, immunological and clinical outcomes in ART‐naïve participants were consistent irrespective of age, immune suppression or VL at ART initiation. While confounding by indication cannot be excluded, this provides reassuring evidence that such subpopulations will equally benefit from contemporary ART.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>32588958</pmid><doi>10.1111/hiv.12888</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-8316-1122</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1464-2662 |
| ispartof | HIV MEDICINE, 2020-10, Vol.21 (9), p.599-606 |
| issn | 1464-2662 1468-1293 |
| language | eng |
| recordid | cdi_swepub_primary_oai_swepub_ki_se_470181 |
| source | Wiley Free Content; Wiley Online Library Journals Frontfile Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; SWEPUB Freely available online |
| subjects | Acquired immune deficiency syndrome Age AIDS Antiretroviral agents antiretroviral naïve Antiretroviral therapy CD4 antigen Clinical trials Consortia Health services HIV Human immunodeficiency virus Immunology Infectious diseases Integrase integrase inhibitors Non-nucleoside reverse transcriptase inhibitors nonnucleoside reverse transcriptase inhibitors Protease Protease inhibitors Proteinase inhibitors Ribonucleic acid RNA RNA-directed DNA polymerase Subpopulations Success |
| title | Treatment outcomes of integrase inhibitors, boosted protease inhibitors and nonnucleoside reverse transcriptase inhibitors in antiretroviral‐naïve persons starting treatment |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-28T08%3A57%3A50IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_swepu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Treatment%20outcomes%20of%20integrase%20inhibitors,%20boosted%20protease%20inhibitors%20and%20nonnucleoside%20reverse%20transcriptase%20inhibitors%20in%20antiretroviral%E2%80%90na%C3%AFve%20persons%20starting%20treatment&rft.jtitle=HIV%20MEDICINE&rft.au=Mocroft,%20A&rft.aucorp=RESPOND%20study%20group&rft.date=2020-10&rft.volume=21&rft.issue=9&rft.spage=599&rft.epage=606&rft.pages=599-606&rft.issn=1464-2662&rft.eissn=1468-1293&rft_id=info:doi/10.1111/hiv.12888&rft_dat=%3Cproquest_swepu%3E2444218153%3C/proquest_swepu%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2444218153&rft_id=info:pmid/32588958&rfr_iscdi=true |