Choice of the initial antiretroviral treatment for HIV-positive individuals in the era of integrase inhibitors

Background We aimed to describe the most frequently prescribed initial antiretroviral therapy (ART) regimens in recent years in HIV-positive persons in the Cohort of the Spanish HIV/AIDS Research Network (CoRIS) and to investigate factors associated with the choice of each regimen. Methods We analyz...

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Autores: Alejos, Belen, Suarez-Garcia, Ines, Bisbal, Otilia, Iribarren, Jose Antonio, Asensi, Victor, Gorgolas, Miguel, Muga, Roberto, Moreno, Santiago, Jarrin, Inma, Dalmau, David, Navarro, Maria Luisa, Gonzalez, Maria Isabel, Blanco, Jose Luis, Garcia, Federico, Rubio, Rafael, Gutierrez, Felix, Vidal, Francesc, Berenguer, Juan, Gonzalez, Juan, Hernando, Victoria, Moreno-Mulet, Cristina, Iniesta, Carlos, Garcia Sousa, Luis Miguel, Sanz Perez, Nieves, Munoz-Fernandez, M. Angeles, Garcia-Merino, Isabel Maria, Consuegra Fernandez, Irene, Gomez Rico, Coral, Gallego de la Fuente, Jorge, Palau Concejo, Paula, Portilla, Joaquin, Merino, Esperanza, Reus, Sergio, Boix, Vicente, Giner, Livia, Gadea, Carmen, Portilla, Irene, Pampliega, Maria, Diez, Marcos, Rodriguez, Juan Carlos, Sanchez-Paya, Jose, Gomez, Juan Luis, Hernandez, Jehovana, Remedios Aleman, Maria, Alonso, Maria del Mar, Hernandez, Maria Inmaculada, Diaz-Flores, Felicitas, Garcia, Dacil, Pelazas, Ricardo, Lopez Lirola, Ana, Sanz Moreno, Jose, Arranz Caso, Alberto, Hernandez Gutierrez, Cristina, Novella Mena, Maria, Pulido, Federico, Hernando, Asuncion, Dominguez, Lourdes, Rial Crestelo, David, Bermejo, Laura, Santacreu, Mireia, Arrizabalaga, Julio, Aramburu, Maria Jose, Camino, Xabier, Rodriguez-Arrondo, Francisco, von Wichmann, Miguel Angel, Pascual Tome, Lidia, Goenaga, Miguel Angel, Bustin-Duy, Ma Jesus, Azkune, Harkaitz, Ibarguren, Maialen, Lizardi, Aitziber, Kortajarena, Xabier, Masia, Mar, Padilla, Sergio, Navarro, Andres, Montolio, Fernando, Robledano, Catalina, Gregori Colome, Joan, Adsuar, Araceli, Pascual, Rafael, Fernandez, Marta, Garcia, Elena, Garcia, Jose Alberto, Barber, Xavier, Sanvisens, Arantza, Fuster, Daniel, Lopez Bernaldo de Quiros, Juan Carlos, Gutierrez, Isabel, Ramirez, Margarita, Padilla, Belen, Gijon, Paloma, Aldamiz-Echevarria, Teresa, Tejerina, Francisco, Parras, Francisco Jose, Balsalobre, Pascual, Diez, Cristina, Perez Latorre, Leire, Peraire, Joaquin, Vilades, Consuelo, Veloso, Sergio, Vargas, Montserrat, Lopez-Dupla, Miguel, Olona, Montserrat, Rull, Anna, Rodriguez-Gallego, Esther, Alba, Veronica, Montero Alonso, Marta, Lopez Aldeguer, Jose, Blanes Julia, Marino, Tasias Pitarch, Maria, Castro Hernandez, Ivan, Calabuig Muñoz, Eva, Cuellar Tovar, Sandra, Salavert Lleti, Miguel, Fernandez Navarro, Juan, Gonzalez-Garcia, Juan, Arnalich, Francisco, Arribas, Jose Ramon, Bernardino de la Serna, Jose Ignacio, Castro, Juan Miguel, Escosa, Luis, Herranz, Pedro, Hontanon, Victor, Garcia-Bujalance, Silvia, Garcia Lopez-Hortelano, Milagros, Gonzalez-Baeza, Alicia, Martin-Carbonero, Maria Luz, Mayoral, Mario, Mellado, Maria Jose, Esteban Mican, Rafael, Montejano, Rocio, Montes, Maria Luisa, Moreno, Victoria, Perez-Valero, Ignacio, Rodes, Berta, Sainz, Talia, Sendagorta, Elena, Stella Alcariz, Natalia, Valencia, Eulalia, Blanco, Jose Ramon, Oteo, Jose Antonio, Ibarra, Valvanera, Metola, Luis, Sanz, Mercedes, Perez-Martinez, Laura, Arazo, Piedad, Samperiz, Gloria, Jaen, Angels, Sanmarti, Montse, Cairo, Mireia, Martinez-Lacasa, Javier, Velli, Pablo, Font, Roser, Xercavins, Mariona, Alonso, Noemi, Rivero, Maria, Reparaz, Jesus, Gracia Ruiz de Alda, Maria, de Leon Cano, Maria Teresa, Pierola Ruiz de Galarreta, Beatriz, Segura, Ferran, Amengual, Maria Jose, Navarro, Gemma, Sala, Montserrat, Cervantes, Manuel, Pineda, Valentin, Calzado, Sonia, Navarro, Marta, de los Santos, Ignacio, Sanz Sanz, Jesus, Salas Aparicio, Ana, Sarria Cepeda, Cristina, Garcia-Fraile , Lucio, Martin Gayo, Enrique, Casado, Jose Luis, Dronda, Fernando, Moreno, Ana, Perez Elias, Maria Jesus, Gomez Ayerbe, Cristina, Gutierrez, Carolina, Madrid, Nadia, del Campo Terron, Santos, Marti, Paloma, Ansa, Uxua, Serrano, Sergio, Vivancos, Maria Jesus, Bernal, Enrique, Cano, Alfredo, Alcaraz Garcia, Antonia, Bravo Urbieta, Joaquin, Munoz, Angeles, Alcaraz, Maria Jose, Villalba, Maria del Carmen, Hernandez, Jose, Pena, Alejandro, Munoz, Leopoldo, Casas, Paz, Alvarez, Marta, Chueca, Natalia, Vinuesa, David, Martinez-Montes, Clara, Del Romero, Jorge, Rodriguez, Carmen, Puerta, Teresa, Carrio, Juan Carlos, Vera, Mar, Ballesteros, Juan, Ayerdi, Oskar, Antela Lopez, Antonio, Losada, Elena, Riera, Melchor, Peñaranda Vera, Maria, Leyes Garcia, Maria, Ribas del Blanco, Maria Àngels, Campins Rosselló, Antoni, Vidal, Carme, Fanjul, Francisco, Murillas Angoiti, Javier, Homar, Francisco, Santos, Jesus, Gomez Ayerbe, Crisitina, Viciana, Isabel, Palacios, Rosario, Gonzalez, Carmen Maria, Viciana, Pompeyo, Espinosa, Nuria, Lopez-Cortes, Luis Fernando, Podzamczer, Daniel, Ferrer, Elena, Imaz, Arkaitz, Tiraboschi, Juan, Silva, Ana, Saumoy, Maria, Ribera, Esteban, Curran, Adrian, Olalla, Julian, del Arco, Alfonso, de la Torre, Javier, Luis Prada, Jose, Garcia de Lomas Guerrero, Jose Maria, Perez Stachowski, Javier, Martinez, Onofre Juan, Vera, Francisco Jesus, Martinez, Lorena, Garcia, Josefina, Alcaraz, Begona, Jimeno, Amaya, Castro Iglesias, Angeles, Pernas Souto, Berta, Mena de Cea, Alvaro, Munoz, Josefa, Zurine Zubero, Miren, Mirena Baraia-Etxaburu, Josu, Ibarra Ugarte, Sofia, Ferrero Beneitez, Oscar Luis, Lopez de Munain, Josefina, Camara Lopez, Ma Mar, de la Pena, Mireia, Lopez, Miriam, Galera, Carlos, Albendin, Helena, Perez, Aurora, Iborra, Asuncion, Moreno, Antonio, Merlos, Maria Angustias, Vidal, Asuncion, Amador, Concha, Pasquau, Francisco, Ena, Javier, Benito, Concha, Fenoll, Vicenta, Gil Anguita, Concepcion, Algado Rabasa, Jose Tomas, Malmierca, Eduardo, Gonzalez-Ruano, Patricia, Martin Rodrigo, Dolores, Ruiz Seco, Ma Pilar, Omar Mohamed-Balghata, Mohamed, Gomez Vidal, Maria Amparo, Alberto de Zarraga, Miguel, Estrada Perez, Vicente, Tellez Molina, Maria Jesus, Vergas Garcia, Jorge, Perez-Somarriba Moreno, Juncal, Cabello, Alfonso, Alvarez, Beatriz, Prieto, Laura, Galindo Puerto, Maria Jose, Fernando Vilalta, Ramon, Ferrer Ribera, Ana, Rivero Roman, Antonio, Brieva Herrero, Maria Teresa, Rivero Juarez, Antonio, Lopez Lopez, Pedro, Machuca Sanchez, Isabel, Pena Martinez, Jose, Cervero Jimenez, Miguel, Torres Perea, Rafael, Jusdado Ruiz-Capillas, Juan Jose, Pineda, Juan A., CoRIS Cohort, Vidal Palacios, Carme
Tipo de recurso: artículo
Fecha de publicación:2019
País:España
Institución:Conselleria de Salut i Consum del Govern de les Illes Balears
Repositorio:Docusalut
Idioma:inglés
OAI Identifier:oai:docusalut.com:20.500.13003/15375
Acceso en línea:https://hdl.handle.net/20.500.13003/15375
Access Level:acceso abierto
Palabra clave:Middle Aged
Integrase Inhibitors
Antiretroviral Therapy, Highly Active
Odds Ratio
HIV Seropositivity
Anti-Retroviral Agents
Female
Adult
Multivariate Analysis
Male
Humans
Persona de Mediana Edad
Humanos
Antirretrovirales
Inhibidores de Integrasa
Oportunidad Relativa
Seropositividad para VIH
Femenino
Análisis Multivariante
Adulto
Terapia Antirretroviral Altamente Activa
Masculino
Descripción
Sumario:Background We aimed to describe the most frequently prescribed initial antiretroviral therapy (ART) regimens in recent years in HIV-positive persons in the Cohort of the Spanish HIV/AIDS Research Network (CoRIS) and to investigate factors associated with the choice of each regimen. Methods We analyzed initial ART regimens prescribed in adults participating in CoRIS from 2014 to 2017. Only regimens prescribed in >5% of patients were considered. We used multivariable multinomial regression to estimate Relative Risk Ratios (RRRs) for the association between sociodemographic and clinical characteristics and the choice of the initial regimen. Results Among 2874 participants, abacavir(ABC)/lamivudine(3TC)/dolutegavir(DTG) was the most frequently prescribed regimen (32.1%), followed by tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC)/elvitegravir(EVG)/cobicistat(COBI) (14.9%), TDF/FTC/rilpivirine (RPV) (14.0%), tenofovir alafenamide (TAF)/FTC/EVG/COBI (13.7%), TDF/FTC+DTG (10.0%), TDF/FTC+darunavir/ritonavir or darunavir/cobicistat (bDRV) (9.8%) and TDF/FTC+raltegravir (RAL) (5.6%). Compared with ABC/3TC/DTG, starting TDF/FTC/RPV was less likely in patients with CD4<200 cells/mu L and HIV-RNA> 100.000 copies/mL. TDF/FTC+DTG was more frequent in those with CD4< 200 cells/mu L and HIV-RNA>100.000 copies/mL. TDF/FTC+FTC+bDRV were also more frequent among patients with CD4< 200 cells//mu L and with transmission categories other than men who have sex with men. Compared with ABC/3TC/DTG, the prescription of other initial ART regimens decreased from 2014-2015 to 2016-2017 with the exception of TDF/FTC+DTG. Differences in the choice of the initial ART regimen were observed by hospitals' location. Conclusions The choice of initial ART regimens is consistent with Spanish guidelines' recommendations, but is also clearly influenced by physician's perception based on patient's clinical and sociodemographic variables and by the prescribing hospital location.

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