Persistence to single-tablet regimen versus less-drug regimen in treatment experienced HIV-infected patients on antiretroviral therapy

Background: Decreased antiretroviral therapy persistence is associated with increased rates of virologic failure, development of antiretroviral resistance, and increased morbidity and mortality. Different therapeutic strategies, such as single-tablet regimens (STR) and less-drug regimens (LDR), have...

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Main Authors: Rocio Jiménez-Galán, Maria-Rosa Cantudo Cuenca, María Aguas Robustillo-Cortés, Y Borrego Izquierdo, Carmen Victoria Almeida- Gonzalez, Ramón Morillo-Verdugo
Format: Article
Language:English
Published: Elsevier 2016-07-01
Series:Farmacia Hospitalaria
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Online Access:http://www.aulamedica.es/fh/pdf/10453.pdf
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author Rocio Jiménez-Galán
Maria-Rosa Cantudo Cuenca
María Aguas Robustillo-Cortés
Y Borrego Izquierdo
Carmen Victoria Almeida- Gonzalez
Ramón Morillo-Verdugo
author_facet Rocio Jiménez-Galán
Maria-Rosa Cantudo Cuenca
María Aguas Robustillo-Cortés
Y Borrego Izquierdo
Carmen Victoria Almeida- Gonzalez
Ramón Morillo-Verdugo
author_sort Rocio Jiménez-Galán
collection DOAJ
description Background: Decreased antiretroviral therapy persistence is associated with increased rates of virologic failure, development of antiretroviral resistance, and increased morbidity and mortality. Different therapeutic strategies, such as single-tablet regimens (STR) and less-drug regimens (LDR), have been developed in order to simplify antiretroviral therapy (ART) and increase persistence. Objectives: The primary objective was to compare antiretroviral persistence among patients receiving STRs and patients receiving LDRs. A secondary objective was to identify factors associated with non-persistence. Methods: This was a retrospective study that included treatment- experienced HIV-infected patients who received ART based on STR or LDR. Baseline patient characteristics collected included demographic information, HIV risk transmission, substance abuse during the therapy, presence of psychiatric disorder and hepatitis B or C virus infection. Kaplan-Meier analysis and Log rank was utilized to compare persistence to STR and LDR. To identify independent predictors of non-persistence we developed a multivariate Cox regression analysis. Results: A total of 244 patients were included, 176 with STR and 68 with LDR. 60 (34.1%) patients discontinued in the STR group and 13 (19.1%) in the LDR group. The Cox regression model showed that the only variable associated with higher risk of non-persistence was the substance abuse (HR = 2.59; p = 0.005). Adverse events were the main reason for ART discontinuation in the STR group and virologic failure in the LDR group. Conclusions: Persistence to STR and LDR seems to be similar in pretreated HIV-infected patients. Drug abuse was the only factor identified with a higher risk of non-persistence.
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spelling doaj-art-cceaab13626c4e7b9f3addcaefef548e2025-01-02T16:24:37ZengElsevierFarmacia Hospitalaria1130-63432171-86952016-07-0140427227810.7399/fh.2016.40.4.10453Persistence to single-tablet regimen versus less-drug regimen in treatment experienced HIV-infected patients on antiretroviral therapyRocio Jiménez-Galán0Maria-Rosa Cantudo Cuenca1María Aguas Robustillo-Cortés2Y Borrego Izquierdo3Carmen Victoria Almeida- Gonzalez4Ramón Morillo-Verdugo5Department of pharmacy. Valme university Hospital, Seville.Department of pharmacy. Valme university Hospital, Seville.María Aguas Robustillo-CortésDepartment of pharmacy. Valme university Hospital, Seville.Research Unit. Valme university Hospital, Seville. Spain.Department of pharmacy. Valme university Hospital, Seville.Background: Decreased antiretroviral therapy persistence is associated with increased rates of virologic failure, development of antiretroviral resistance, and increased morbidity and mortality. Different therapeutic strategies, such as single-tablet regimens (STR) and less-drug regimens (LDR), have been developed in order to simplify antiretroviral therapy (ART) and increase persistence. Objectives: The primary objective was to compare antiretroviral persistence among patients receiving STRs and patients receiving LDRs. A secondary objective was to identify factors associated with non-persistence. Methods: This was a retrospective study that included treatment- experienced HIV-infected patients who received ART based on STR or LDR. Baseline patient characteristics collected included demographic information, HIV risk transmission, substance abuse during the therapy, presence of psychiatric disorder and hepatitis B or C virus infection. Kaplan-Meier analysis and Log rank was utilized to compare persistence to STR and LDR. To identify independent predictors of non-persistence we developed a multivariate Cox regression analysis. Results: A total of 244 patients were included, 176 with STR and 68 with LDR. 60 (34.1%) patients discontinued in the STR group and 13 (19.1%) in the LDR group. The Cox regression model showed that the only variable associated with higher risk of non-persistence was the substance abuse (HR = 2.59; p = 0.005). Adverse events were the main reason for ART discontinuation in the STR group and virologic failure in the LDR group. Conclusions: Persistence to STR and LDR seems to be similar in pretreated HIV-infected patients. Drug abuse was the only factor identified with a higher risk of non-persistence.http://www.aulamedica.es/fh/pdf/10453.pdfHIV; Medication persistenceAntiretroviral therapy
spellingShingle Rocio Jiménez-Galán
Maria-Rosa Cantudo Cuenca
María Aguas Robustillo-Cortés
Y Borrego Izquierdo
Carmen Victoria Almeida- Gonzalez
Ramón Morillo-Verdugo
Persistence to single-tablet regimen versus less-drug regimen in treatment experienced HIV-infected patients on antiretroviral therapy
Farmacia Hospitalaria
HIV
; Medication persistence
Antiretroviral therapy
title Persistence to single-tablet regimen versus less-drug regimen in treatment experienced HIV-infected patients on antiretroviral therapy
title_full Persistence to single-tablet regimen versus less-drug regimen in treatment experienced HIV-infected patients on antiretroviral therapy
title_fullStr Persistence to single-tablet regimen versus less-drug regimen in treatment experienced HIV-infected patients on antiretroviral therapy
title_full_unstemmed Persistence to single-tablet regimen versus less-drug regimen in treatment experienced HIV-infected patients on antiretroviral therapy
title_short Persistence to single-tablet regimen versus less-drug regimen in treatment experienced HIV-infected patients on antiretroviral therapy
title_sort persistence to single tablet regimen versus less drug regimen in treatment experienced hiv infected patients on antiretroviral therapy
topic HIV
; Medication persistence
Antiretroviral therapy
url http://www.aulamedica.es/fh/pdf/10453.pdf
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