Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Nov 19;9(12):ofac628.
doi: 10.1093/ofid/ofac628. eCollection 2022 Dec.

Determinants of Antiretroviral Treatment Success and Adherence in People With Human Immunodeficiency Virus Treated for Tuberculosis

Nathalie De Castro  1   2 , Corine Chazallon  1 , Jean-Baptiste N'takpe  1   3 , Isabel Timana  4 , Rodrigo Escada  5 , Sandra Wagner  5 , Eugène Messou  3   6 , Serge Eholie  3   7 , Nilesh Bhatt  4 , Celso Khosa  4 , Didier Laureillard  8   9 , Giang Do Chau  10 , Valdilea G Veloso  4 , Constance Delaugerre  11   12   13 , Xavier Anglaret  1 , Jean-Michel Molina  2   12   13 , Beatriz Grinsztejn  4 , Olivier Marcy  1 ; ANRS 12300 Reflate TB2 Study Group
Affiliations

Determinants of Antiretroviral Treatment Success and Adherence in People With Human Immunodeficiency Virus Treated for Tuberculosis

Nathalie De Castro et al. Open Forum Infect Dis. .

Abstract

Background: In people with human immunodeficiency virus [HIV] presenting with advanced disease, rates of virologic success may be lower than expected. The Reflate TB2 trial did not show non-inferiority of raltegravir versus efavirenz in people with HIV (PWH) treated for tuberculosis. We aimed to identify factors associated with virologic success and higher adherence in the trial.

Methods: In this analysis, we included participants enrolled in the Reflate TB2 trial with adherence data available. The primary outcome was virologic success (HIV-1 ribonucleic acid [RNA] <50 copies/mL) at week 48, and the secondary outcome was adherence as assessed by the pill count adherence ratio. We used logistic regression to study determinants of virologic success and optimal adherence in 2 separate analyses.

Results: Four hundred forty-four participants were included in the present analysis. Over the 48-week follow-up period, 290 of 444 (65%) participants had a pill count adherence ratio ≥95%. At week 48, 288 of 444 (65%) participants were in virologic success. In the multivariate analysis, female sex (adjusted odds ratio [aOR], 1.77; 95% confidence interval [CI], 1.16-2.72; P = .0084), lower baseline HIV-1 RNA levels (<100 000; aOR, 2.29; 95% CI, 1.33-3.96; P = .0087), and pill count adherence ratio ≥95% (aOR, 2.38; 95% CI, 1.56-3.62; P < .0001) were independently associated with virologic success. Antiretroviral pill burden was the only factor associated with pill count adherence ratio ≥95% (OR, 0.81; 95% CI, .71-.92; P = .0018).

Conclusions: In PWH with tuberculosis receiving raltegravir or efavirenz-based regimens, female sex, optimal adherence, and baseline HIV-1 RNA <100 000 copies/mL were associated with virologic success, and the number of antiretroviral tablets taken daily was a strong predictor of adherence.

Keywords: HIV viral load; adherence; raltegravir; tuberculosis.

PubMed Disclaimer

References

    1. Global Tuberculosis Report 2021. Available athttps://www.who.int/teams/global-tuberculosis-programme/tb-reports/globa.... Accessed 17 July 2022.
    1. Blanc F-X, Sok T, Laureillard D, et al. . Earlier versus later start of antiretroviral therapy in HIV-infected adults with tuberculosis. N Engl J Med 2011; 365:1471–81. - PMC - PubMed
    1. INSIGHT START Study Group, Lundgren JD, Babiker AG, Gordin F, et al. . Initiation of antiretroviral therapy in early asymptomatic HIV infection. N Engl J Med 2015; 373:795–807. - PMC - PubMed
    1. TEMPRANO ANRS 12136 Study Group, Danel C, Moh R, Gabillard D, et al. . A trial of early antiretrovirals and isoniazid preventive therapy in Africa. N Engl J Med 2015; 373: 808–22. - PubMed
    1. World Health Organization . Updated recommendations on first-line and second-line antiretroviral regimens and post-exposure prophylaxis and recommendations on early infant diagnosis of HIV. Available athttp://www.who.int/hiv/pub/guidelines/ARV2018update/en/. Accessed 17 July 2022.