Accès ouvert déclaré2020article
Clinical Outcomes of 2-Drug Regimens vs 3-Drug Regimens in Antiretroviral Treatment–Experienced People Living With Human Immunodeficiency Virus
Lauren Greenberg, Lene Ryom, Bastian Neesgaard, Gilles Wandeler, Thérèse Staub, Martin Gisinger, Michael Skoll, Huldrych F. Günthard, Alexandra Scherrer, Cristina Mussini, Colette Smith, Margaret Johnson, Stéphane De Wit, Coca Necsoi, Christian Pradier, Ferdinand W.N.M. Wit, Clara Lehmann, Antonella d’Arminio Monforte, José M. Miró, Antonella Castagna, Vincenzo Spagnuolo, Anders Sönnerborg, Matthew Law, Jolie Hutchinson, Nikoloz Chkhartishvili, N Bolokadze, Jan‐Christian Wasmuth, Christoph Stephan, Vani Vannappagari, Felipe Rogatto, Josep M. Llibre, Claudine Duvivier, Jennifer Hoy, Mark Bloch, Heiner C. Bucher, Alexandra Calmy, Alain Volny Anne, Annegret Pelchen–Matthews, Jens Lundgren, Lars Peters, Loveleen Bansi‐Matharu, Amanda Mocroft, Peter Reiss, M Hillebregt, Kathy Petoumenos, Norman Rose, Robert Zangerle, H Appoyer, M Delforge, M Bucht, Otar Chokoshvili, A Rodano, Alessandro Tavelli, Iuri Fanti, Vanni Borghi, Éric Fontas, K Dollet, C Caissotti, J Casabona, Antoni Riéra, J. Uruena, Fiona Lampe, Adriano Lazzarin, Andrea Poli, A Sönnerborg, Karolin Falconer, V Svedhem, B Ledergerber, J C Wasmuth, Jörg Janne Vehreschild, Gerd Fätkenheuer, Amanda Mocroft, James F. Rooney, H Garges, J. Kowalska, David Raben, J Rockstroh, N Dedes, E. D. Williams, Andreu Bruguera, Richard Haubrich, V Svedhem-Johansson, Katharina Grabmeier‐Pfistershammer, Dominique L. Braun, Gundolf Schüttfort, M Youle, Stefano Zona, Andrea Antinori, Carolynne Schwarze‐Zander, J H Wasmuth, Gordana Dragović, Roxana Rădoi, C. Oprea, M Vasylyev, Raimonda Matulionytė, V Mulabdic, G Marchetti, Elena Kuzovatova, Nicola Coppola, Josip Begovać, Inka Aho, Salvatore Martini, Arjan Harxhi, Torgun Wæhre, Anastasia Pharris, Anna Vassilenko, J. R. Bogner, Anne Maagaard, Elżbieta Jabłonowska, Daniel Elbirt, Gaetano Marrone, Clifford Leen, Christoph Wyen, M Kundro, Emily D. Williams, Joel E. Gallant, David Thorpe, Helena Díaz-Cuervo, Alain Volny‐Anne, Luís Mendão, Jens Fromholt Larsen, Marie Louise Jakobsen, T Bruun, Anders Bojesen, E V Hansen, T W Elsing, Daniel Tuyet Kristensen, Simon Francis Thomsen, T Weide, D Byonanebye
22Citations signalées
36Institutions associées
15Pays d’affiliation
Résumé fourni par la source
BACKGROUND: Limited data exist that compare clinical outcomes of 2-drug regimens (2DRs) and 3-drug regimens (3DRs) in people living with human immunodeficiency virus. METHODS: Antiretroviral treatment-experienced individuals in the International Cohort Consortium of Infectious Diseases (RESPOND) who switched to a new 2DR or 3DR from 1 January 2012-1 October 2018 were included. The incidence of clinical events (AIDS, non-AIDS cancer, cardiovascular disease, end-stage liver and renal disease, death) was compared between regimens using Poisson regression. RESULTS: Of 9791 individuals included, 1088 (11.1%) started 2DRs and 8703 (88.9%) started 3DRs. The most common 2DRs were dolutegravir plus lamivudine (22.8%) and raltegravir plus boosted darunavir (19.8%); the most common 3DR was dolutegravir plus 2 nucleoside reverse transcriptase inhibitors (46.9%). Individuals on 2DRs were older (median, 52.6 years [interquartile range, 46.7-59.0] vs 47.7 [39.7-54.3]), and a higher proportion had ≥1 comorbidity (81.6% vs 73.9%). There were 619 events during 27 159 person-years of follow-up (PYFU): 540 (incidence rate [IR] 22.5/1000 PYFU; 95% confidence interval [CI]: 20.7-24.5) on 3DRs and 79 (30.9/1000 PYFU; 95% CI: 24.8-38.5) on 2DRs. The most common events were death (7.5/1000 PYFU; 95% CI: 6.5-8.6) and non-AIDS cancer (5.8/1000 PYFU; 95% CI: 4.9-6.8). After adjustment for baseline demographic and clinical characteristics, there was a similar incidence of events on both regimen types (2DRs vs 3DRs IR ratio, 0.92; 95% CI: .72-1.19; P = .53). CONCLUSIONS: This is the first large, international cohort to assess clinical outcomes on 2DRs. After accounting for baseline characteristics, there was a similar incidence of events on 2DRs and 3DRs. 2DRs appear to be a viable treatment option with regard to clinical outcomes. Further research on resistance barriers and long-term durability of 2DRs is needed.
Sujets associés
HIV/AIDS drug development and treatmentHIV-related health complications and treatmentsHIV/AIDS Research and Interventions