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Evolution in Real-World Therapeutic Strategies for HIV Treatment: A Retrospective Study in Southern Italy, 2014–2020

Changes in HIV treatment guidelines over the last two decades reflect the evolving challenges in this field. Our study examined treatment change patterns throughout a 7-year period in a large Italian cohort of HIV patients as well as the reasons and direction of changes. Treatment-naïve and -experie...

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Autores principales: Papa, Nunzia, Cammarota, Simona, Citarella, Anna, Atripaldi, Luigi, Bernardi, Francesca F., Fogliasecca, Marianna, Giugliano, Nello, Trama, Ugo, Spatarella, Micaela
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8745745/
https://www.ncbi.nlm.nih.gov/pubmed/35011902
http://dx.doi.org/10.3390/jcm11010161
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author Papa, Nunzia
Cammarota, Simona
Citarella, Anna
Atripaldi, Luigi
Bernardi, Francesca F.
Fogliasecca, Marianna
Giugliano, Nello
Trama, Ugo
Spatarella, Micaela
author_facet Papa, Nunzia
Cammarota, Simona
Citarella, Anna
Atripaldi, Luigi
Bernardi, Francesca F.
Fogliasecca, Marianna
Giugliano, Nello
Trama, Ugo
Spatarella, Micaela
author_sort Papa, Nunzia
collection PubMed
description Changes in HIV treatment guidelines over the last two decades reflect the evolving challenges in this field. Our study examined treatment change patterns throughout a 7-year period in a large Italian cohort of HIV patients as well as the reasons and direction of changes. Treatment-naïve and -experienced HIV patients managed by Cotugno Hospital of Naples between 2014 and 2020 were analyzed. During the period, the proportion of single-tablet regimen treatment sharply increased for the naïve and experienced patients. Regimens containing integrase strand transfer inhibitors rapidly replaced those containing protease inhibitor and non-nucleoside reverse transcriptase inhibitors. The use of the tenofovir alafenamide fumarate/emtricitabine backbone increased rapidly after its introduction in the Italian pharmaceutical market, making up 63.7 and 54.9% of all treatments in naïve and experienced patients, respectively, in 2020. The main reason for treatment changes was optimization and/or simplification (90.6% in 2018; 85.3% in 2019; 95.5 in 2020) followed by adverse effects and virological failure. Our real-world analysis revealed that the majority of treatment-naïve and treatment-experienced patients received antiretroviral drugs listed as preferred/recommended in current recommendations. Regimen optimization and/or simplification is a leading cause of treatment modification, while virologic failure or adverse effects are less likely reasons for modification in the current treatment landscape.
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spelling pubmed-87457452022-01-11 Evolution in Real-World Therapeutic Strategies for HIV Treatment: A Retrospective Study in Southern Italy, 2014–2020 Papa, Nunzia Cammarota, Simona Citarella, Anna Atripaldi, Luigi Bernardi, Francesca F. Fogliasecca, Marianna Giugliano, Nello Trama, Ugo Spatarella, Micaela J Clin Med Article Changes in HIV treatment guidelines over the last two decades reflect the evolving challenges in this field. Our study examined treatment change patterns throughout a 7-year period in a large Italian cohort of HIV patients as well as the reasons and direction of changes. Treatment-naïve and -experienced HIV patients managed by Cotugno Hospital of Naples between 2014 and 2020 were analyzed. During the period, the proportion of single-tablet regimen treatment sharply increased for the naïve and experienced patients. Regimens containing integrase strand transfer inhibitors rapidly replaced those containing protease inhibitor and non-nucleoside reverse transcriptase inhibitors. The use of the tenofovir alafenamide fumarate/emtricitabine backbone increased rapidly after its introduction in the Italian pharmaceutical market, making up 63.7 and 54.9% of all treatments in naïve and experienced patients, respectively, in 2020. The main reason for treatment changes was optimization and/or simplification (90.6% in 2018; 85.3% in 2019; 95.5 in 2020) followed by adverse effects and virological failure. Our real-world analysis revealed that the majority of treatment-naïve and treatment-experienced patients received antiretroviral drugs listed as preferred/recommended in current recommendations. Regimen optimization and/or simplification is a leading cause of treatment modification, while virologic failure or adverse effects are less likely reasons for modification in the current treatment landscape. MDPI 2021-12-29 /pmc/articles/PMC8745745/ /pubmed/35011902 http://dx.doi.org/10.3390/jcm11010161 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Papa, Nunzia
Cammarota, Simona
Citarella, Anna
Atripaldi, Luigi
Bernardi, Francesca F.
Fogliasecca, Marianna
Giugliano, Nello
Trama, Ugo
Spatarella, Micaela
Evolution in Real-World Therapeutic Strategies for HIV Treatment: A Retrospective Study in Southern Italy, 2014–2020
title Evolution in Real-World Therapeutic Strategies for HIV Treatment: A Retrospective Study in Southern Italy, 2014–2020
title_full Evolution in Real-World Therapeutic Strategies for HIV Treatment: A Retrospective Study in Southern Italy, 2014–2020
title_fullStr Evolution in Real-World Therapeutic Strategies for HIV Treatment: A Retrospective Study in Southern Italy, 2014–2020
title_full_unstemmed Evolution in Real-World Therapeutic Strategies for HIV Treatment: A Retrospective Study in Southern Italy, 2014–2020
title_short Evolution in Real-World Therapeutic Strategies for HIV Treatment: A Retrospective Study in Southern Italy, 2014–2020
title_sort evolution in real-world therapeutic strategies for hiv treatment: a retrospective study in southern italy, 2014–2020
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8745745/
https://www.ncbi.nlm.nih.gov/pubmed/35011902
http://dx.doi.org/10.3390/jcm11010161
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