A retrospective study of HIV antiretroviral treatment persistence in a commercially insured population in the United States

Juday, Timothy; Grimm, Kristy; Zoe-Powers, Annette; Willig, James H.; Kim, Edward

doi:10.1080/09540121.2010.543884

Cited by 33 publications

(33 citation statements)

References 16 publications

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“…This result is similar to other longitudinal studies [26, 27]. PIs have a lower number of resistance mutations for reverse transcriptase enzymes compared to NNRTIs, which justifies this drug choice in preventing failure.…”

Section: Discussionsupporting

confidence: 89%

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: Discussionsupporting

confidence: 89%

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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“…43,44 We also found that women were more likely to discontinue ART in all 3 models, consistent with other studies on ART persistence. 22,28 More frequent HIV medication side effects and toxicity reported by women compared with men 45,46 may account for the lower ART persistence observed in women. We found that injection drug use in the past 12 months was associated with significantly increased odds of discontinuing ART, which is consistent with other studies.…”

Section: Discussionmentioning

confidence: 99%

“…18–21 Examinations of the prevalence and predictors of ART discontinuation have demonstrated that certain patients are more likely to discontinue ART. Substance use, 22 injection drug use, 23 disease severity, 14,22,24,25 younger age, 14,25,26 racial/ethnic minorities, 26,27 female gender, 22,28 unemployment, 28 perceived HIV stigma, 29 fear of discrimination, 30 mental health, 14,24,28,31,32 and side effects 33 have been associated with ART discontinuation. However, these studies lack generalizability since they were conducted on subpopulations of HIV-infected patients, such as patients from 1 or a small group of clinics or hospitals, women only, or patients with a history of substance abuse.…”

Section: Introductionmentioning

confidence: 99%

Discontinuation of Antiretroviral Therapy Among Adults Receiving HIV Care in the United States

Hughes

Mattson

Scheer

et al. 2014

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background Continuous antiretroviral therapy (ART) is important for maintaining viral suppression. This analysis estimates prevalence of and reason for ART discontinuation. Methods Three-stage sampling was used to obtain a nationally representative, cross-sectional sample of HIV-infected adults receiving HIV care. Face-to-face interviews and medical record abstractions were collected from June 2009 to May 2010. Data were weighted based on known probabilities of selection and adjusted for nonresponse. Patient characteristics of ART discontinuation, defined as not currently taking ART, stratified by provider-initiated versus non–provider-initiated discontinuation, were examined. Weighted logistic regression models predicted factors associated with ART discontinuation. Results Of adults receiving HIV care in the United States who reported ever initiating ART, 5.6% discontinued treatment. Half of those who discontinued treatment reported provider-initiated discontinuation. Provider-initiated ART discontinuation patients were more likely to have a nadir CD4 ≥200 cells per cubic millimeter. Non–provider-initiated ART discontinuation patients were more likely to have unmet need for supportive services and to have not received HIV care in the past 3 months. Among all patients who discontinued, younger age, female gender, not having continuous health insurance, incarceration, injection drug use, nadir CD4 count ≥200 cells per cubic millimeter, unmet need for supportive services, no care in the past 3 months and HIV diagnosis ≥5 years before interview were independently associated with ART discontinuation. Conclusions These findings inform development of interventions to increase ART persistence by identifying groups at increased risk of ART discontinuation. Evidence-based interventions targeting vulnerable populations are needed and are increasingly important as recent HIV treatment guidelines have recommended universal ART.

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“…The aforementioned selection criteria were applied to all medication groups. For ART users, we included only those using valid regimens, defined as those receiving a minimum of three different antiretroviral ingredients [5, 15, 16]. ACEI and ARB users were combined into one group.…”

Section: Methodsmentioning

confidence: 99%

Ten-year trends in antiretroviral therapy persistence among US Medicaid beneficiaries

Youn

Shireman

Lee

et al. 2017

Aids

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Objective Whether the rate of HIV antiretroviral therapy (ART) persistence has improved over time in the United States is unknown. We examined ART persistence trends between 2001 and 2010, using non-HIV medications as a comparator. Methods We conducted a retrospective cohort study using Medicaid claims. We defined persistence as the duration of treatment from the first to the last fill date before a 90-day permissible gap and used Kaplan–Meier curves and Cox proportional hazard models to assess crude and adjusted nonpersistence. The secular trends of ART persistence in 43 598 HIV patients were compared with the secular trends of persistence with angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers (ACEI/ARB), statins, and metformin in non-HIV-infected patients and subgroups of HIV patients who started these control medications while using ART. Results Median time to ART nonpersistence increased from 23.9 months in 2001– 2003 to 35.4 months in 2004–2006 and was not reached for those starting ART in 2007–2010. In adjusted models, ART initiators in 2007–2010 had 11% decreased hazard of nonpersistence compared with those who initiated in 2001–2003 (P < 0.001). For non-HIV patients initiating angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEI/ARB), statins, and metformin, the hazard ratios for nonpersistence comparing 2007–2010 to 2001–2003 were 1.07, 0.94, and 1.02, respectively (all P < 0.001). For HIV patients initiating the three control medications, the hazard ratios of nonpersistence comparing 2007–2010 to 2001–2003 were 0.71, 0.65, and 0.63, respectively (all P < 0.001). Conclusion Persistence with ART improved between 2001 and 2010. Persistence with control medications improved at a higher rate among HIV patients using ART than HIV-negative controls.

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A retrospective study of HIV antiretroviral treatment persistence in a commercially insured population in the United States

Cited by 33 publications

References 16 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

Discontinuation of Antiretroviral Therapy Among Adults Receiving HIV Care in the United States

Ten-year trends in antiretroviral therapy persistence among US Medicaid beneficiaries

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