Durability of the first combined antiretroviral regimen in patients with AIDS at a reference center in Belo Horizonte, Brazil, from 1996 to 2005

Abstract

Finding a better first antiretroviral regimen is one of the strategies used to improve span and quality of life of HIV/AIDS patients. 891 patients were followed during 24 months or until interruption/abandonment of treatment, changing regimen or death. At the end of 6 months, 69% of the patients were still being treated with the first regimen, 54% at 12 months, 48% at 18 months and 39% at 24 months. AZT-3TC-EFV was the most prescribed regimen and with the lesser discontinuation. NNRTI regimens showed high effectiveness and durability compared to PI regimens. Irregular medication dispensation was the only risk factor for failure/interruption of treatment in multivariate analyses. Intolerance/adverse effects were mainly responsible for first regimen discontinuation, followed by abandonment/non-adherence and virologic failure. Results showed significant difference between causes of interruption of first HAART with higher percentage of intolerance/adverse effects with PI regimens and higher immunologic failure with NNRTI regimens. Even with the availability of more potent and tolerable drugs, lack of adherence to HAART and high level of adverse effects are still the most important barriers to prolonged success of treatment. This study adds relevant information about durability and effectiveness of HAART in the first decade of its use in Brazil.

Determinants of Highly Active Antiretroviral Therapy Duration in HIV-1-Infected Children and Adolescents in Madrid, Spain, from 1996 to 2012

“…Some observational surveys corroborate our results, showing high rates of initial regimen discontinuation [33]–[35]. Concerning the duration of the initial HAART regimen in HIV-infected adults, Chen R.Y.…”

The HIV-Brazil Cohort Study: Design, Methods and Participant Characteristics

“…The impact of the Brazilian policy has been the object of nationwide studies, mostly focused on mortality [9], [10], [14], [15], the impact on the health system [1], [5], [16] and HIV resistance surveillance [17], [18], as well as small studies with limited representativeness, evaluating the clinical aspects of HIV infection [8], [11], [19] and the use of cART [20]–[24]. However, to date, there have been no nationwide longitudinal studies providing a broader picture of the Brazilian HIV epidemic and the results of the national HIV policy.…”

A study of utilization pattern of drugs in HIV positive patients at antiretroviral therapy centre of a tertiary care teaching hospital

“…16,18 Protease inhibitor based regimes cause more intolerance/adverse effects and non nucleoside reverse transcriptase inhibitor based regimes has higher rate of immunologic failure. 19 Because of side effects, dosage and drug interactions, non nucleoside reverse transcriptase inhibitors are preferable to protease inhibitors in HAART combinations. As per world health organization recommendation, first line ART should be one non nucleoside reverse transcriptase inhibitor with two nucleoside reverse transcriptase inhibitors.…”

“…These findings are in consonance with findings of other studies. 6,7,19 Higher usage of lamivudine can be due to its good safety profile and its ability to restore susceptibility to zidovudine and tenofovir. 2 The most common prescribed protease inhibitor in this study was ritonavir boosted atazanavir (1.00%), which was ritonavir boosted lopinavir in previous similar studies.…”