Stecher, Melanie, Schommers, Philipp ORCID: 0000-0003-3375-6800, Kollan, Christian, Stoll, Matthias, Kuhlendahr, Frieder, Stellbrink, Hans-Juergen, Wasmuth, Jan-Christian, Stephan, Christoph, Hamacher, Laura, Lehmann, Clara, Boesecke, Christoph, Bogner, Johannes, Esser, Stefan, Fritzsche, Carlos, Haberl, Annette, Hoffmann, Christian, Jensen, Bjoern, Schwarze-Zander, Carolynne, Platten, Martin, Faetkenheuer, Gerd, Schmidt, Daniel, Gunsenheimer-Bartmeyer, Barbara and Vehreschild, Joerg Janne (2020). Treatment modification after starting cART in people living with HIV: retrospective analysis of the German ClinSurv HIV Cohort 2005-2017. Infection, 48 (5). S. 723 - 734. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1439-0973

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Abstract

Objective Combination antiretroviral therapy (cART) has markedly increased survival and quality of life in people living with HIV. With the advent of new treatment options, including single-tablet regimens, durability and efficacy of first-line cART regimens are evolving. Methods We analyzed data from the prospective multicenter German Clinical Surveillance of HIV Disease (ClinSurv) cohort of the Robert-Koch Institute. Kaplan-Meier and Cox proportional hazards models were run to examine the factors associated with treatment modification. Recovery after treatment initiation was analyzed comparing pre-cART viral load and CD4+ T-cell counts with follow-up data. Results We included 8788 patients who initiated cART between 2005 and 2017. The sample population was predominantly male (n = 7040; 80.1%), of whom 4470 (63.5%) were reporting sex with men as the transmission risk factor. Overall, 4210 (47.9%) patients modified their first-line cART after a median time of 63 months (IQR 59-66). Regimens containing integrase strand transfer inhibitors (INSTI) were associated with significantly lower rates of treatment modification (adjusted hazard ratio 0.44; 95% CI 0.39-0.50) compared to protease inhibitor (PI)-based regimens. We found a decreased durability of first-line cART significantly associated with being female, a low CD4+ T-cell count, cART initiation in the later period (2011-2017), being on a multi-tablet regimen (MTR). Conclusions Drug class and MTRs are significantly associated with treatment modification. INSTI-based regimens showed to be superior compared to PI-based regimens in terms of durability.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Stecher, MelanieUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schommers, PhilippUNSPECIFIEDorcid.org/0000-0003-3375-6800UNSPECIFIED
Kollan, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stoll, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kuhlendahr, FriederUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stellbrink, Hans-JuergenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wasmuth, Jan-ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stephan, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hamacher, LauraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lehmann, ClaraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Boesecke, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bogner, JohannesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Esser, StefanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fritzsche, CarlosUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Haberl, AnnetteUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hoffmann, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jensen, BjoernUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schwarze-Zander, CarolynneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Platten, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Faetkenheuer, GerdUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schmidt, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gunsenheimer-Bartmeyer, BarbaraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vehreschild, Joerg JanneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-328167
DOI: 10.1007/s15010-020-01469-6
Journal or Publication Title: Infection
Volume: 48
Number: 5
Page Range: S. 723 - 734
Date: 2020
Publisher: SPRINGER HEIDELBERG
Place of Publication: HEIDELBERG
ISSN: 1439-0973
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
ACTIVE ANTIRETROVIRAL THERAPY; INTEGRASE INHIBITORS; REGIMEN DURABILITY; DISCONTINUATION; COMBINATION; INFECTION; ADHERENCE; SUCCESS; DRUGS; NAIVEMultiple languages
Infectious DiseasesMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/32816

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