Document Detail


The impact of HIV drug resistance testing on changes to treatment.
MedLine Citation:
PMID:  21297420     Owner:  NLM     Status:  MEDLINE    
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; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  AIDS (London, England)     Volume:  25     ISSN:  1473-5571     ISO Abbreviation:  AIDS     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-03-03     Completed Date:  2011-07-07     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  8710219     Medline TA:  AIDS     Country:  England    
Other Details:
Languages:  eng     Pagination:  603-10     Citation Subset:  IM; X    
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-Retroviral Agents / administration & dosage*
Data Collection
Drug Administration Schedule
Drug Resistance, Viral* / drug effects,  genetics
Female
Genotype
HIV Infections / drug therapy,  genetics*,  virology
HIV-1 / drug effects*,  genetics
Humans
Male
Microbial Sensitivity Tests
Retreatment*
Treatment Outcome
Viral Load
Grant Support
ID/Acronym/Agency:
G0000199//Medical Research Council; G0600337//Medical Research Council; G0900274//Medical Research Council; MC_U122886351//Medical Research Council
Chemical
Reg. No./Substance:
0/Anti-Retroviral Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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