| Title: |
Clinical Outcomes of 2-Drug Regimens vs 3-Drug Regimens in Antiretroviral Treatment–Experienced People Living With Human Immunodeficiency Virus |
| Authors: |
Greenberg, L; Ryom, L; Neesgaard, B; Wandeler, G; Staub, T; Gisinger, M; Skoll, M; Günthard, HF; Scherrer, A; Mussini, C; Smith, C; Johnson, M; De Wit, S; Necsoi, C; Pradier, C; Wit, F; Lehmann, C; D'Arminio Monforte, A; Miró, JM; Castagna, A; Spagnuolo, V; Sönnerborg, A; Law, M; Hutchinson, J; Chkhartishvili, N; Bolokadze, N; Wasmuth, J-C; Stephan, C; Vannappagari, V; Rogatto, F; Llibre, JM; Duvivier, C; Hoy, J; Bloch, M; Bucher, HC; Calmy, A; Volny Anne, A; Pelchen-Matthews, A; Lundgren, JD; Peters, L; Bansi-Matharu, L; Mocroft, A; RESPOND study group |
| Source: |
Clinical Infectious Diseases , 73 (7) e2323-e2333. (2021) |
| Publication Year: |
2021 |
| Collection: |
University College London: UCL Discovery |
| Subject Terms: |
HIV; antiretroviral treatment; clinical outcomes; dual therapy; two-drug regimens |
| Description: |
BACKGROUND: Limited data exist comparing clinical outcomes of two-drug regimens (2DRs) and three-drug regimens (3DRs) in people living with HIV. METHODS: Antiretroviral treatment-experienced individuals in RESPOND switching to a new 2DR or 3DR from 1/1/12-1/10/18 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%) 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% CI 20.7-24.5]) on 3DRs, 79 (30.9/1000 PYFU [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 [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 [0.72-1.19]; p=0.53). CONCLUSIONS: This is the first large, international cohort assessing 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. |
| Document Type: |
article in journal/newspaper |
| File Description: |
text |
| Language: |
English |
| Relation: |
https://discovery.ucl.ac.uk/id/eprint/10118378/1/ciaa1878.pdf; https://discovery.ucl.ac.uk/id/eprint/10118378/ |
| Availability: |
https://discovery.ucl.ac.uk/id/eprint/10118378/1/ciaa1878.pdf; https://discovery.ucl.ac.uk/id/eprint/10118378/ |
| Rights: |
open |
| Accession Number: |
edsbas.2E89C5FD |
| Database: |
BASE |