| 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.; Gunthard H. F.; Scherrer A.; Mussini C.; Smith C.; Johnson M.; De Wit S.; Necsoi C.; Pradier C.; Wit F.; Lehmann C.; d'Arminio Monforte A.; Miro J. M.; Castagna A.; Spagnuolo V.; Sonnerborg A.; Law M.; Hutchinson J.; Chkhartishvili N.; Bolokadze N.; Wasmuth J. -C.; Stephan C.; Vannappagari V.; Rogatto F.; Llibre J. M.; Duvivier C.; Hoy J.; Bloch M.; Bucher H. C.; Calmy A.; Volny Anne A.; Pelchen-Matthews A.; Lundgren J. D.; Peters L.; Bansi-Matharu L.; Mocroft A. |
| Contributors: |
L. Greenberg; L. Ryom; B. Neesgaard; G. Wandeler; T. Staub; M. Gisinger; M. Skoll; H.F. Gunthard; A. Scherrer; C. Mussini; C. Smith; M. Johnson; S. De Wit; C. Necsoi; C. Pradier; F. Wit; C. Lehmann; A. d'Arminio Monforte; J.M. Miro; A. Castagna; V. Spagnuolo; A. Sonnerborg; M. Law; J. Hutchinson; N. Chkhartishvili; N. Bolokadze; J.-. Wasmuth; C. Stephan; V. Vannappagari; F. Rogatto; J.M. Llibre; C. Duvivier; J. Hoy; M. Bloch; H.C. Bucher; A. Calmy; A. Volny Anne; A. Pelchen-Matthew; J.D. Lundgren; L. Peter; L. Bansi-Matharu; A. Mocroft |
| Publisher Information: |
NLM (Medline) |
| Publication Year: |
2021 |
| Collection: |
The University of Milan: Archivio Istituzionale della Ricerca (AIR) |
| Subject Terms: |
2-drug regimen; antiretroviral treatment; clinical outcome; dual therapy; HIV; Anti-Retroviral Agent; Human; Anti-HIV Agent; HIV Infection; Pharmaceutical Preparations; Settore MED/17 - Malattie Infettive |
| Description: |
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. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/33354721; info:eu-repo/semantics/altIdentifier/wos/WOS:000729829500151; volume:73; issue:7; firstpage:e2323; lastpage:e2333; numberofpages:11; journal:CLINICAL INFECTIOUS DISEASES; https://hdl.handle.net/2434/898594 |
| DOI: |
10.1093/cid/ciaa1878 |
| Availability: |
https://hdl.handle.net/2434/898594; https://doi.org/10.1093/cid/ciaa1878 |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.E121D034 |
| Database: |
BASE |