부산대학교 도서관

Background Until the past decade, immune/viral failure was the main reason for antiretroviral treatment changes. After HAART generalization the management of antiretroviral treatment toxicities was the most prevalent reason for treatment modification. Today, with the advent of new more potent and less toxic drugs as well as more convenient combinations may have changed the situation. We aim to describe the main reasons that today leads to ART changes in HIV+ patients in Spain in the current clinical practice. Methods Multicentre, national, cross-sectional epidemiological study. Eligible patients had to be HIV+, >18 years old and under current ART that was going to be changed by any reason. Patients did sign inform consent. The study consisted in a single visit (change of treatment) in which data on social and demographic characteristics, HIV disease and ARV treatment were collected. Results 349 patients were included; mean age: 43.7±8.9 y, 70.5% male and 89.1% Caucasian. Main transmission categories were IVDU (36.4%) and heterosexual (36.4%). Mean time from HIV diagnosis was 11.3±7.6 y. 59.5% were CDC C category. Median CD4 nadir was: 155 cells/mm3 and median CD4 at the time of switching was 467 cells/mm3. 64.1% had undetectable viral load (<50 copies/ml); 40.1% had HCV or HBV co-infection. Main reasons for treatment change were simplification (40.2%), treatment toxicities (29.2%) and immune/viral failure (20.1%). No significant correlations were found between reason for changing treatment and age, gender, race, nationality and level of education. Simplification was significantly the main reason both in employed and unemployed patients (p<0.01). Conclusions Currently, treatment simplification was the most prevalent reason for a change of treatment even in advanced lines of treatment. This is so probably because of the advent of ARV drugs that are more potent and effective, with less toxicity and more convenient. Treatment simplification was significantly the first cause of treatment change in those patients who are currently working or seeking for a job. This highlights the need for simpler regimens that can adapt to an active life. [ABSTRACT FROM AUTHOR]