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. 2011 Sep;27(9):957-63.
doi: 10.1089/AID.2010.0291. Epub 2011 Mar 21.

The role of toxicity-related regimen changes in the development of antiretroviral resistance

Christa R Nevin  1 , Jiatao Ye, Inmaculada Aban, Michael J Mugavero, David Jackson, Hui-Yi Lin, Jeroan Allison, James L Raper, Michael S Saag, James H Willig
Affiliations

The role of toxicity-related regimen changes in the development of antiretroviral resistance

Christa R Nevin et al. AIDS Res Hum Retroviruses. 2011 Sep.

Abstract

In an effort to evaluate factors associated with the development of antiretroviral (ARV) resistance, we assessed the prevalence of toxicity-related regimen changes and modeled its association to the subsequent development of ARV resistance in a cohort of treatment-naive individuals initiating ARV therapy (ART). A retrospective analysis of patients initiating ART was conducted at the UAB 1917 Clinic from 1 January 2000 to 30 September 2007. Cox proportional hazards models were fit to identify factors associated with the development of resistance to ≥1 ARV drug class. Among 462 eligible participants, 14% (n=64) developed ARV resistance. Individuals with ≥1 toxicity-related regimen change (HR=3.94, 95% CI=1.09-14.21), initiating ART containing ddI or d4T (4.12, 1.19-14.26), and from a minority race (2.91, 1.16-7.28) had increased risk of developing resistance. Achieving virologic suppression within 12 months of ART initiation (0.10, 0.05-0.20) and higher pretreatment CD4 count (0.85 per 50 cells/mm(3), 0.75-0.96) were associated with decreased hazards of resistance. Changes in ART due to drug intolerance were associated with the subsequent development of ARV resistance. Understanding the role of ARV drug selection and other factors associated with the emergence of ARV resistance will help inform interventions to improve patient care and ensure long-term treatment success.

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References

    1. Hogg RS. O'Shaughnessy MV. Gataric N. Yip B. Craib K. Schechter MT. Montaner JS. Decline in deaths from AIDS due to new antiretrovirals. Lancet. 1997;349:1294. - PubMed
    1. Maggiolo F. Ripamonti D. Airoldi M. Callegaro A. Arici C. Ravasio V. Bombana E. Goglio A. Suter F. Resistance costs and future drug options of antiretroviral therapies: Analysis of the role of NRTIs, NNRTIs, and PIs in a large clinical cohort. HIV Clin Trials. 2007;8:9–18. - PubMed
    1. Palella FJ., Jr Delaney KM. Moorman AC. Loveless MO. Fuhrer J. Satten GA. Aschman DJ. Holmberg SD. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. HIV Outpatient Study Investigators. N Engl J Med. 1998;338:853–860. - PubMed
    1. Hogg RS. Bangsberg DR. Lima VD. Alexander C. Bonner S. Yip B. Wood E. Dong WW. Montaner JS. Harrigan PR. Emergence of drug resistance is associated with an increased risk of death among patients first starting HAART. PLoS Med. 2006;3:e356. - PMC - PubMed
    1. Mauro Z. Federica F. Patrizia L. Francesca CS. Valerio T. Paola TM. Patrizia M. Pasquale N. Federico PC. Andrea A. Continuous evidence of fast HIV disease progression related to class-wide resistance to antiretroviral drugs: A 6 year follow-up analysis of a large observational database. AIDS. 2007;21:1824–1826. - PubMed

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