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Effect of once-daily FDC treatment era on initiation of cART
OBJECTIVES: Combination antiretroviral therapy (cART) is associated with increased survival among HIV-infected persons. Yet, no research to date has examined whether introduction of once-daily fixed-dosed combinations (FDC) affects the likelihood of cART initiation. We aimed to determine whether imp...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove Medical Press
2010
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3218687/ https://www.ncbi.nlm.nih.gov/pubmed/22096381 |
Sumario: | OBJECTIVES: Combination antiretroviral therapy (cART) is associated with increased survival among HIV-infected persons. Yet, no research to date has examined whether introduction of once-daily fixed-dosed combinations (FDC) affects the likelihood of cART initiation. We aimed to determine whether implementation of once-daily FDC regimens was associated with changes to cART initiation. We also identified clinical, treatment regimen, and provider characteristics possibly associated with cART initiation. STUDY DESIGN: Retrospective observational analysis. METHODS: We queried electronic medical records between July 1999–June 2006 to identify incident cases of detectable HIV infection in antiretroviral-naïve adults. Cox regression with time-dependent covariates was used to examine the effects of once-daily FDC era, clinical, provider, and treatment regimen characteristics on cART initiation. RESULTS: Once-daily FDC availability did not change the likelihood of cART initiation, but other characteristics were associated with an increased likelihood: AIDS diagnosis, above-median daily pill consumption, and 16+ yrs of physician HIV experience. Decreased likelihood of cART initiation was associated with CD4 201–350 cells/μL, HIV RNA < 100,000 copies/mL, and with CD4 > 350 cells/μL (any HIV RNA level), compared to CD4 ≤ 200 cells/μL. CONCLUSION: Availability of once-daily FDC-based regimens did not affect likelihood of cART initiation. Patient clinical characteristics appear to be more important predictors of cART initiation. |
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