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Effectiveness and risk factors for virological outcome of darunavir-based therapy for treatment-experienced HIV-infected patients
OBJECTIVE: We evaluated the effectiveness of darunavir (DRV) treatment plus an optimized background regimen in 120 HIV-1 treatment-experienced patients. DESIGN: Retrospective cohort, multicenter study. METHODS: Adults >16 years with virological treatment failure starting therapy with a DRV-contai...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4582634/ https://www.ncbi.nlm.nih.gov/pubmed/26413132 http://dx.doi.org/10.1186/s12981-015-0072-9 |
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author | Mata-Marín, José Antonio Huerta-García, Gloria Domínguez-Hermosillo, Juan Carlos Chavez-García, Marcelino Banda-Lara, Marco Isaac Nuñez-Rodríguez, Nohemí Cruz-Herrera, Javier Enrique Sandoval-Ramírez, Jorge Luis Martínez-Abarca, Ivan Villagómez-Ruíz, Alfredo Francisco Manjarrez-Tellez, Bulmaro Gaytán-Martínez, Jesús |
author_facet | Mata-Marín, José Antonio Huerta-García, Gloria Domínguez-Hermosillo, Juan Carlos Chavez-García, Marcelino Banda-Lara, Marco Isaac Nuñez-Rodríguez, Nohemí Cruz-Herrera, Javier Enrique Sandoval-Ramírez, Jorge Luis Martínez-Abarca, Ivan Villagómez-Ruíz, Alfredo Francisco Manjarrez-Tellez, Bulmaro Gaytán-Martínez, Jesús |
author_sort | Mata-Marín, José Antonio |
collection | PubMed |
description | OBJECTIVE: We evaluated the effectiveness of darunavir (DRV) treatment plus an optimized background regimen in 120 HIV-1 treatment-experienced patients. DESIGN: Retrospective cohort, multicenter study. METHODS: Adults >16 years with virological treatment failure starting therapy with a DRV-containing regimen were included. Effectiveness was evaluated as the percentage of patients with an undetectable HIV-1 RNA viral load (<50 and <200 copies/mL) after 48 weeks, and changes in CD4+ cell counts. We evaluated the risk factors associated with treatment failure. RESULTS: Of the cohort, 83 % were men with a median age of 45 years (interquartile range, IQR 40–51). They had experienced treatment for a median of 13 years (IQR 9–17) with a median of six previous regimens (IQR 4–7), all using protease inhibitors. After treatment, 82 % (95 % confidence interval, CI 74–88 %) of patients had an HIV-1 RNA viral load <200 copies/mL and 69 % (95 % CI 60–76 %) had <50 copies/mL. The CD4+ cell count increased by 378 cells/μL (IQR 252–559; P < 0.001 vs. baseline). Risk factors associated with poor outcome were age >40 years [odds ratio, OR 0.15 (95 % CI 0.10–0.78); P = 0.015], use of raltegravir in the regimen [OR 0.37 (95 % CI 0.10–0.97); P = 0.046], and baseline CD4+ cell count <200 cells/μL [OR 2.79 (95 % CI 1.11–6.97); P = 0.028]. CONCLUSION: In this Mexican cohort Darunavir was metabolically safe, well tolerated and achieved high rates of virological suppression in highly treatment-experienced patients infected with HIV-1. |
format | Online Article Text |
id | pubmed-4582634 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-45826342015-09-26 Effectiveness and risk factors for virological outcome of darunavir-based therapy for treatment-experienced HIV-infected patients Mata-Marín, José Antonio Huerta-García, Gloria Domínguez-Hermosillo, Juan Carlos Chavez-García, Marcelino Banda-Lara, Marco Isaac Nuñez-Rodríguez, Nohemí Cruz-Herrera, Javier Enrique Sandoval-Ramírez, Jorge Luis Martínez-Abarca, Ivan Villagómez-Ruíz, Alfredo Francisco Manjarrez-Tellez, Bulmaro Gaytán-Martínez, Jesús AIDS Res Ther Research OBJECTIVE: We evaluated the effectiveness of darunavir (DRV) treatment plus an optimized background regimen in 120 HIV-1 treatment-experienced patients. DESIGN: Retrospective cohort, multicenter study. METHODS: Adults >16 years with virological treatment failure starting therapy with a DRV-containing regimen were included. Effectiveness was evaluated as the percentage of patients with an undetectable HIV-1 RNA viral load (<50 and <200 copies/mL) after 48 weeks, and changes in CD4+ cell counts. We evaluated the risk factors associated with treatment failure. RESULTS: Of the cohort, 83 % were men with a median age of 45 years (interquartile range, IQR 40–51). They had experienced treatment for a median of 13 years (IQR 9–17) with a median of six previous regimens (IQR 4–7), all using protease inhibitors. After treatment, 82 % (95 % confidence interval, CI 74–88 %) of patients had an HIV-1 RNA viral load <200 copies/mL and 69 % (95 % CI 60–76 %) had <50 copies/mL. The CD4+ cell count increased by 378 cells/μL (IQR 252–559; P < 0.001 vs. baseline). Risk factors associated with poor outcome were age >40 years [odds ratio, OR 0.15 (95 % CI 0.10–0.78); P = 0.015], use of raltegravir in the regimen [OR 0.37 (95 % CI 0.10–0.97); P = 0.046], and baseline CD4+ cell count <200 cells/μL [OR 2.79 (95 % CI 1.11–6.97); P = 0.028]. CONCLUSION: In this Mexican cohort Darunavir was metabolically safe, well tolerated and achieved high rates of virological suppression in highly treatment-experienced patients infected with HIV-1. BioMed Central 2015-09-24 /pmc/articles/PMC4582634/ /pubmed/26413132 http://dx.doi.org/10.1186/s12981-015-0072-9 Text en © Mata-Marín et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Mata-Marín, José Antonio Huerta-García, Gloria Domínguez-Hermosillo, Juan Carlos Chavez-García, Marcelino Banda-Lara, Marco Isaac Nuñez-Rodríguez, Nohemí Cruz-Herrera, Javier Enrique Sandoval-Ramírez, Jorge Luis Martínez-Abarca, Ivan Villagómez-Ruíz, Alfredo Francisco Manjarrez-Tellez, Bulmaro Gaytán-Martínez, Jesús Effectiveness and risk factors for virological outcome of darunavir-based therapy for treatment-experienced HIV-infected patients |
title | Effectiveness and risk factors for virological outcome of darunavir-based therapy for treatment-experienced HIV-infected patients |
title_full | Effectiveness and risk factors for virological outcome of darunavir-based therapy for treatment-experienced HIV-infected patients |
title_fullStr | Effectiveness and risk factors for virological outcome of darunavir-based therapy for treatment-experienced HIV-infected patients |
title_full_unstemmed | Effectiveness and risk factors for virological outcome of darunavir-based therapy for treatment-experienced HIV-infected patients |
title_short | Effectiveness and risk factors for virological outcome of darunavir-based therapy for treatment-experienced HIV-infected patients |
title_sort | effectiveness and risk factors for virological outcome of darunavir-based therapy for treatment-experienced hiv-infected patients |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4582634/ https://www.ncbi.nlm.nih.gov/pubmed/26413132 http://dx.doi.org/10.1186/s12981-015-0072-9 |
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