Determinants of highly active antiretroviral therapy duration in HIV-1-infected...

• Autor(es): Palladino, Claudia ; Briz, Verónica ; Bellón, José María ; Climent, Francisco J. ; De Ory, Santiago J. ; Mellado, María José ; Navarro, María Luisa ; Ramos, José T. ; Taveira, Nuno ; De José, María Isabel ; Munõz-Fernandes, María Ángeles ; CoRISpeS-Madrid Cohort Working Group
• Data: 2014
• Origem: Repositório Comum
• Assunto(s): Antiretroviral therapy; HIV-1; Highly-active antiretroviral therapy; Adolescents; Children; Madrid
• Tipo de Documento: Artigo
• Idioma: Inglês

Descrição

"Objectives: To investigate the duration of sequential HAART regimens and predictors of first-line regimen discontinuation among HIV-1 vertically infected children and adolescents. Design: Multicentre survey of antiretroviral-naı¨ve patients enrolled in the HIV-Paediatric Cohor,t CoRISpeS-Madrid Cohort, Spain. Methods: Patients with a follow-up of $1 month spent on HAART, with available baseline CD4 count and HIV-viral load (VL) were included. Time spent on sequential HAART regimens was estimated and multivariable regression was used to identify predictors of time to first-line regimen discontinuation. Results: 104 patients were followed for a median 8 years after starting HAART among 1996–2012; baseline %CD4 was 21.5 (12.3–34.0)and viral load was 5.1 (4.6–5.6) log10 copies/mL. Patients received a mean of 1.9 regimens. Median time on firstline HAART (n = 104) was 64.5 months; second HAART (n = 56) 69.8 months; and third HAART (n = 21) 66.5 months. Eleven (11%) patients were lost to follow-up while on first-line HAART and 54% discontinued (cumulative incidence of 16% and 38% by 1 and 3-year, respectively). The main predictor of first-line regimen discontinuation was suboptimal adherence to antiretrovirals (AHR: 2.60; 95% CI: 1.44–4.70). Conclusions: Adherence to therapy was the main determinant of the duration of the first-line HAART regimen in children. It is important to identify patients at high risk for non-adherence, such as very young children and adolescents, in provide special care and support to those patients."