Durability of different initial regimens in HIV-infected patients starting antiretroviral therapy with CD4+ counts <200 cells/mm3 and HIV-RNA >5 log10 copies/mL
- Creators
- Gianotti N.
- Lorenzini P.
- Cozzi-Lepri A.
- De Luca A.
- Madeddu G.
- Sighinolfi L.
- Pinnetti C.
- Santoro C.
- Meraviglia P.
- Mussini C.
- Antinori A.
- D'Arminio Monforte A.
- Andreoni M.
- Angarano G.
- Castelli F.
- Cauda R.
- Di Perri G.
- Galli M.
- Iardino R.
- Ippolito G.
- Lazzarin A.
- Perno C. F.
- Von Schloesser F.
- Viale P.
- Castagna A.
- Ceccherini-Silberstein F.
- Girardi E.
- Lo Caputo S.
- Puoti M.
- Ammassari A.
- Balotta C.
- Bandera A.
- Bonfanti P.
- Bonora S.
- Borderi M.
- Calcagno A.
- Calza L.
- Capobianchi M. R.
- Cingolani A.
- Cinque P.
- Di Biagio A.
- Gori A.
- Guaraldi G.
- Lapadula G.
- Lichtner M.
- Maggiolo F.
- Marchetti G.
- Marcotullio S.
- Monno L.
- Nozza S.
- Quiros Roldan E.
- Rossotti R.
- Rusconi S.
- Saracino A.
- Zaccarelli M.
- Fanti I.
- Rodano A.
- Shanyinde M.
- Tavelli A.
- Carletti F.
- Carrara S.
- Di Caro A.
- Graziano S.
- Petrone F.
- Prota G.
- Quartu S.
- Truffa S.
- Giacometti A.
- Costantini A.
- Valeriani C.
- Suardi C.
- Donati V.
- Verucchi G.
- Quiros E.
- Minardi C.
- Quirino T.
- Abeli C.
- Manconi P. E.
- Piano P.
- Cacopardo B.
- Celesia B.
- Vecchiet J.
- Falasca K.
- Segala D.
- Mazzotta F.
- Vichi F.
- Cassola G.
- Viscoli C.
- Alessandrini A.
- Bobbio N.
- Mazzarello G.
- Mastroianni C.
- Belvisi V.
- Caramma I.
- Chiodera A.
- Rizzardini G.
- Ridolfo A. L.
- Piolini R.
- Carenzi L.
- Moioli M. C.
- Tincati C.
- Puzzolante C.
- Abrescia N.
- Chirianni A.
- Borgia G.
- Di Martino F.
- Maddaloni L.
- Gentile I.
- Orlando R.
- Baldelli F.
- Francisci D.
- Parruti G.
- Ursini T.
- Magnani G.
- Ursitti M. A.
- Vullo V.
- Cristaudo A.
- Baldin G.
- Cicalini S.
- Gallo L.
- Nicastri E.
- Acinapura R.
- Capozzi M.
- Libertone R.
- Savinelli S.
- Latini A.
- Cecchetto M.
- Viviani F.
- Mura M. S.
- Rossetti B.
- Caramello P.
- C Orofino G.
- Sciandra M.
- Bassetti M.
- Londero A.
- Pellizzer G.
- Manfrin V.
- Others:
- Gianotti, N.
- Lorenzini, P.
- Cozzi-Lepri, A.
- De Luca, A.
- Madeddu, G.
- Sighinolfi, L.
- Pinnetti, C.
- Santoro, C.
- Meraviglia, P.
- Mussini, C.
- Antinori, A.
- D'Arminio Monforte, A.
- Andreoni, M.
- Angarano, G.
- Castelli, F.
- Cauda, R.
- Di Perri, G.
- Galli, M.
- Iardino, R.
- Ippolito, G.
- Lazzarin, A.
- Perno, C. F.
- Von Schloesser, F.
- Viale, P.
- Castagna, A.
- Ceccherini-Silberstein, F.
- Girardi, E.
- Lo Caputo, S.
- Puoti, M.
- Ammassari, A.
- Balotta, C.
- Bandera, A.
- Bonfanti, P.
- Bonora, S.
- Borderi, M.
- Calcagno, A.
- Calza, L.
- Capobianchi, M. R.
- Cingolani, A.
- Cinque, P.
- Di Biagio, A.
- Gori, A.
- Guaraldi, G.
- Lapadula, G.
- Lichtner, M.
- Maggiolo, F.
- Marchetti, G.
- Marcotullio, S.
- Monno, L.
- Nozza, S.
- Quiros Roldan, E.
- Rossotti, R.
- Rusconi, S.
- Saracino, A.
- Zaccarelli, M.
- Fanti, I.
- Rodano, A.
- Shanyinde, M.
- Tavelli, A.
- Carletti, F.
- Carrara, S.
- Di Caro, A.
- Graziano, S.
- Petrone, F.
- Prota, G.
- Quartu, S.
- Truffa, S.
- Giacometti, A.
- Costantini, A.
- Valeriani, C.
- Suardi, C.
- Donati, V.
- Verucchi, G.
- Quiros, E.
- Minardi, C.
- Quirino, T.
- Abeli, C.
- Manconi, P. E.
- Piano, P.
- Cacopardo, B.
- Celesia, B.
- Vecchiet, J.
- Falasca, K.
- Segala, D.
- Mazzotta, F.
- Vichi, F.
- Cassola, G.
- Viscoli, C.
- Alessandrini, A.
- Bobbio, N.
- Mazzarello, G.
- Mastroianni, C.
- Belvisi, V.
- Caramma, I.
- Chiodera, A.
- Rizzardini, G.
- Ridolfo, A. L.
- Piolini, R.
- Carenzi, L.
- Moioli, M. C.
- Tincati, C.
- Puzzolante, C.
- Abrescia, N.
- Chirianni, A.
- Borgia, G.
- Di Martino, F.
- Maddaloni, L.
- Gentile, I.
- Orlando, R.
- Baldelli, F.
- Francisci, D.
- Parruti, G.
- Ursini, T.
- Magnani, G.
- Ursitti, M. A.
- Vullo, V.
- Cristaudo, A.
- Baldin, G.
- Cicalini, S.
- Gallo, L.
- Nicastri, E.
- Acinapura, R.
- Capozzi, M.
- Libertone, R.
- Savinelli, S.
- Latini, A.
- Cecchetto, M.
- Viviani, F.
- Mura, M. S.
- Rossetti, B.
- Caramello, P.
- C Orofino, G.
- Sciandra, M.
- Bassetti, M.
- Londero, A.
- Pellizzer, G.
- Manfrin, V.
Description
Objectives: Our aim was to investigate the durability of different initial regimens in patients starting ART with CD4+ counts <200 cells/mm3 and HIV-RNA >5 log10 copies/mL. Methods: This was a retrospective study of HIV-infected patients prospectively followed in the ICONA cohort. Those who started ART with boosted protease inhibitors (bPIs), NNRTIs or integrase strand transfer inhibitors (InSTIs), with CD4+ <200 cells/mm3 and HIV-RNA >5 log10 copies/mL, were included. The primary endpoint was treatment failure (TF), a composite endpoint defined as virological failure (VF, first of two consecutive HIV-RNA >50 copies/mL after 6 months of treatment), discontinuation of class of the anchor drug or death. Independent associations were investigated by Poisson regression analysis in a model including age, gender, mode of HIV transmission, CDC stage, HCV and HBV co-infection, pre-treatment HIV-RNA, CD4+ count and CD4+/CD8+ ratio, ongoing opportunistic disease, fibrosis FIB-4 index, estimated glomerular filtration rate, haemoglobin, platelets, neutrophils, calendar year of ART initiation, anchor drug class (treatment group) and nucleos(t)ide backbone. Results: A total of 1195 patients fulfilled the inclusion criteria: 696 started ART with a bPI, 315 with an InSTI and 184 with an NNRTI. During 2759 person-years of follow up, 642 patients experienced TF. Starting ART with bPIs [adjusted incidence rate ratio (aIRR) (95% CI) 1.62 (1.29-2.03) versus starting with NNRTIs; P<0.001] and starting ART with InSTIs [aIRR (95% CI) 0.68 (0.48-0.96) versus starting with NNRTIs; P=0.03] were independently associated with TF. Conclusions: In patients starting ART with <200 CD4+ cells/mm3 and >5 log10 HIV-RNA copies/mL, the durability of regimens based on InSTIs was longer than that of NNRTI- and bPI-based regimens.
Additional details
- URL
- http://hdl.handle.net/11567/1001398
- URN
- urn:oai:iris.unige.it:11567/1001398
- Origin repository
- UNIGE