DI-076 Interruption and discontinuation of highly active antiretroviral therapy in psitar hiv cohort

Abstract

BackgroundTreatment modifications within the first year are extremely important. The first HAART regimen should remain for years. The first regimen toxicity can have a negative impact on adherence and virological efficacy.PurposeTo establish the main reason for discontinuing antiretroviral treatment within the first year in an HIV cohort.Material and methodsProspective multicentre study. Treatment-naive adult HIV patients who started treatment between 2011 and 2013 were selected. Basic demographic characteristics (sex and age) and pharmacotherapeutic variables as initial HAART, discontinuation of HAART within the first year and its reasons based on Swiss HIV Cohort1 were collected. The main reasons for treatment modification were classified as treatment failure, intolerance and/or toxic effects, the patient’s choice, the physician’s decision, and other reasons.Results277 patients started HAART in this period, 82.4% men. The mean age was 40 ± 11. The most frequent HAART was emtricitabine/tenofovir/efavirenz (59.1%) followed by emtricitabine, tenofovir, atazanavir/ritonavir (13.6%), emtricitabine, tenofovir, darunavir/ritonavir (9.1%) and other combinations (18.2%). During the first year of HAART, 68 individuals modified their treatment. The reason for treatment discontinuation was: 64.7% intolerance or toxic effects, 16.2% the physician’s decision 10.3% treatment failure, 4.4% the patient’s decision and 4.4% other reasons. 44 patients modified their treatment because of drug intolerance and/or drug toxicity. CNS adverse events were the most frequent toxic effect (27.3%), followed by gastrointestinal tract intolerance and renal impairment (18.2%), rash (9.1%), biochemical alterations (6.8%) and others (18.2%).ConclusionThe number of patients stopping HAART in the first year is acceptable. It is necessary to properly assess starting HAART to reduce adverse reactions involving switching the treatment.ReferenceElzi L, Marzolini C, Furrer H, et al. Treatment modification in human immunodeficiency virus-infected individuals starting combination antiretroviral therapy between 2005 and 2008. Arch Intern Med 2010;170(1):57–65. doi:10.1001/archinternmed.2009.432No conflict of interest.

Antiretroviral therapy interruptions: impact on HIV treatment and transmission

“…Recently published PSITAR cohort study results reemphasizes why treatment interruption is a viable alternative in the right population as it reported ART modification in 68 of 277 participants with recently diagnosed HIV during the first year of therapy with the main reason for discontinuation of therapy being intolerance or toxic effects of medication (64%), followed by provider’s decision (16%) and treatment failure (10%). 25 …”