1. Nuke-sparing regimens as a main simplification strategy and high level of toxicity resolution after antiretroviral switch: the SWITCHART Study
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Carrero?Gras, Ana, Antela, Antonio, Muñoz?Rodríguez, Jessica, Díaz?Menéndez, Marta, Viciana, Pompeyo, Torrella?Domingo, Adriadna, Sanz?Moreno, José, Téllez?Molina, María Jesús, Moreno, Javier, Hernández?Quero, José, Pérez?Hernández, Isabel A., and Domingo?Pedrol, Pere
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Antiviral agents -- Dosage and administration ,Drugs -- Health aspects ,HIV infection -- Risk factors -- Prevention ,Health - Abstract
Background: The advent of combined antiretroviral therapy (ART) in the past decade has led to HIV suppression in most cases. Virological failure was the main reason for ART switch a few years ago; however, toxicity and treatment simplification have now gained importance due to the availability of more effective and convenient drugs. This study assessed the reasons for ART switch in daily practice. Material and Methods: Observational retrospective study that included patients whose ART was switched between January 2011 and July 2012. Patients with any other switch during the follow‐up period (until September 2013) were excluded. Results: A total of 246 patients were included. Main reasons for ART switch were simplification (33%) and toxicity (31%), followed by clinical trial inclusion (13%), virological failure (6%), drug interaction (4%), patient decision (3%), lack of adherence (2%), pregnancy (1%) and other (8%). Eighty patients switched to a simpler regimen (median age 48 [40–53], mean CD4 count 608±265 cells/cl, 89% Conclusions: The main reasons for ART switch in daily practice are simplification and toxicities, renal and CNS toxicities being the most prevalent. The preferred simplification strategies are nuke‐sparing regimens, mainly DRV/r‐based monotherapy and dual therapy. ART switch leads to a complete resolution of toxicities in most cases in the short term., Figure 1: Antiretroviral therapy before and after treatment simplification (N=80). [Figure omitted] Figure 2: Main toxicities before and after switching the antiretroviral therapy (N=77). [Figure omitted] DOI: [...]
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- 2014
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