Fatores determinantes para modificações da terapia antirretroviral inicial

Lima, Denise Girão Limaverde; Arruda, Érico Antônio Gomes de; Lima, Antonio Jorge Alves de; Oliveira, Bruna Esmeraldo; Fonteles, Marta Maria de França

doi:10.1590/s0104-42302012000200019

Cited by 6 publications

(3 citation statements)

References 11 publications

(17 reference statements)

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“…The incidence of ART modification was higher than that found by other Brazilian and international observational studies [16–19]. This can be explained by different outcome definitions, which can regard discontinuation, modification, or switch to second-line treatment as ART modification.…”

Section: Discussionmentioning

confidence: 60%

Incidence and Predictors of Antiretroviral Treatment Modification in HIV-Infected Adults: A Brazilian Historical Cohort from 2001 to 2010

Braga

Mendicino

Reis

et al. 2017

Journal of Tropical Medicine

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This study estimated the incidence of and time to first antiretroviral therapy (ART) modification. This longitudinal analysis comprised a sample of 236 patients from three HIV/AIDS referral centers in Belo Horizonte, Brazil—part of a major historical cohort. Inclusion criteria were as follows: having been treatment-naive patient ≥18 years old who initiated ART between 2001 and 2005 in these three referral centers. The main endpoint was time to first ART modification. Patients were followed up for five years, covering the period 2001–2010, during which time Pearson's chi-square test was performed to compare ART modification between groups. Kaplan-Meier inverse survival curves were employed to describe the probability of ART modification and Cox proportional hazard regression was used to estimate the adjusted hazard ratio (aHR) of ART modification. Among 247 patients from the major cohort, 236 were eligible. Median follow-up time was 37.2 months and the contribution in person-months was 7,615.4 months. A total of 108 (45.8%) patients had their ART regimen modified at least once (incidence rate: 1.42 per 100 person-months). Adverse drug reactions were the main reason for ART modification. Women (aHR = 1.62; p = 0.022) and patients on protease inhibitor- (PI-) based regimens (aHR = 2.70; p < 0.001) were at higher risk of ART modification.

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Section: Discussionmentioning

confidence: 60%

Incidence and Predictors of Antiretroviral Treatment Modification in HIV-Infected Adults: A Brazilian Historical Cohort from 2001 to 2010

Braga

Mendicino

Reis

et al. 2017

Journal of Tropical Medicine

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“…Advances in treatment have severely impacted the course of the disease, reducing morbidity and mortality and improving the quality of life of people living with HIV (PLHIV). However, there are adverse events associated with antiretroviral use as well as other factors that contribute to poor adherence and to the discontinuation of treatment and may lead to therapeutic failure and an accumulation of mutations [3]. Dolutegravir (DTG) is an integrase inhibitor that was incorporated into the Brazilian pharmacological arsenal as of January 2017.…”

Section: Introductionmentioning

confidence: 99%

Dolutegravir: Virologic response and tolerability of initial antiretroviral regimens for adults living with HIV

et al. 2020

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The integrase inhibitor dolutegravir was included in initial antiretroviral therapy in Brazil in January 2017. Studies have demonstrated that the efficacy and safety of antiretrovirals have improved with the introduction of new classes of antiretrovirals, such as integrase inhibitors. This study aimed to estimate the frequency of individuals with a virologic response by week 24 of antiretroviral treatment and to describe the adverse events of the regimen containing dolutegravir. This was a cohort of people living with HIV followed up at a referral hospital. Patients were included who had initiated their first treatment between January and August 2017. Data were obtained from medical records, the Drug Logistics Management System and from the Laboratory Tests Control System. Two hundred and twenty-two patients were included for the tolerability analysis and one hundred and thirty-seven for the virologic response analysis. The mean age was 34 years, the median time between diagnosis and initiating treatment was 1.9 months and the median time on antiretroviral therapy was 13.2 months. The frequency of adverse events was 10% (95% CI: 7% to 15.2%), of these, amongst the most frequent events, 91% presented gastrointestinal effects, and 47.8% neuropsychiatric. By week 24 the estimated incidence of virologic response was 89.1% (95% CI: 83% to 93.5%), with an increase during the first 6 months in the number of T-CD4 lymphocytes of 50.7 cells/mm 3 (95% CI: 42 to 59.3). Initial antiretroviral regimens containing dolutegravir were well tolerated and effective in viral suppression during the first 24 weeks after initiating treatment. The occurrence of adverse events was low, either mild or moderate.

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“…quanto à tolerabilidade e abandono de tratamento por qualquer causa(126). Trabalho realizado em 2008, por sua vez, que buscou fatores determinantes para a troca de TARV no primeiro ano de terapia, observou que Zidovudina (ITRN) e Lopinavir (IP) foram os antirretrovirais mais submetidos a trocas devido à anemia e efeitos gastrointestinais, respectivamente(127). outras que quando não diagnosticadas ou reconhecidas tardiamente, têm consequências graves tanto no âmbito individual quanto no coletivo.…”

unclassified

Fatores associados ao abandono do seguimento e tratamento antirretroviral entre pacientes soropositivos para o vírus da imunodeficiência humana acompanhados no Centro de Referência DST/Aids de Campinas-SP

Lima¹

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IC 95%: 0,04 -0,91) apareceram como fatores preditores do seguimento e uso de TARV. Variáveis associadas à vulnerabilidade socioeconômica associaram-se positivamente ao abandono enquanto maior escolaridade e o atendimento do paciente por equipe multiprofissional parecem prevenir a sua ocorrência.Palavras chave: HIV, Síndrome de Imunodeficiência Adquirida, adesão à medicação, terapia antirretroviral de alta atividade.

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Fatores determinantes para modificações da terapia antirretroviral inicial

Abstract: The main factor determining changes in the initial ART was an adverse reaction report. Most patients had one change in the initial ART over the first year of treatment. ART monitoring contributed to a better control of the specific drug therapy.

Cited by 6 publications

References 11 publications

Incidence and Predictors of Antiretroviral Treatment Modification in HIV-Infected Adults: A Brazilian Historical Cohort from 2001 to 2010

Incidence and Predictors of Antiretroviral Treatment Modification in HIV-Infected Adults: A Brazilian Historical Cohort from 2001 to 2010

Dolutegravir: Virologic response and tolerability of initial antiretroviral regimens for adults living with HIV

Fatores associados ao abandono do seguimento e tratamento antirretroviral entre pacientes soropositivos para o vírus da imunodeficiência humana acompanhados no Centro de Referência DST/Aids de Campinas-SP

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