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The impact of HIV drug resistance testing on changes to treatment.
MedLine Citation:
PMID:  21297420     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: We investigate changes made to therapy after a resistance test result and identify factors associated with switching regimen. METHODS:: Patients receiving antiretroviral therapy (ART) who had a resistance test performed during 1998-2007 were included in the analysis. A switch was defined as starting at least two drugs/starting a drug from a class not previously experienced within 4 months of the resistance test result. Logistic regression was used to identify factors independently associated with switching regimen. RESULTS:: Of the 5123 test results included in the analyses, 1874 (36.6%) were followed by a switch within 4 months of the test result. Independent factors associated with switching included genotypic sensitivity score (GSS) of the current regimen [odds ratio (OR) 4.86, 95% confidence interval (CI) 3.95, 5.97 for GSS less than 1 compared to GSS of at least 3] and a higher number of previous failures [1.12 (1.06, 1.18) per additional failed regimen]. Patients with fewer drug options were less likely to switch [0.36 (0.27, 0.48) comparing 0-3 drug options with ≥10 drug options]. CONCLUSIONS:: Only 37% of patients switched regimen within 4 months of the resistance test result. Whilst toxicity concerns of available drugs may somewhat explain this finding, it is also likely that there is a lack of treatment options available for patients who did not switch.
Authors:
Loveleen Bansi; Colette Smith; Andrew Phillips; Stuart Kirk; Anna-Maria Geretti; Margaret Johnson; Nicola Mackie; Frank Post; Brian Gazzard; David Dunn; Caroline Sabin;
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-3
Journal Detail:
Title:  AIDS (London, England)     Volume:  -     ISSN:  1473-5571     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8710219     Medline TA:  AIDS     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
aResearch Department of Infection and Population Health, UCL Medical School, UK bUniversity College London Hospitals, UK cRoyal Free Hampstead NHS Trust & UCL Medical School, UK dImperial College Healthcare National Health Service Trust, UK eKing's College London School of Medicine, UK fChelsea and Westminster Hospital, UK gMRC Clinical Trials Unit, London, UK.
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