Back to Search
Start Over
Forgiveness of Dolutegravir-Based Triple Therapy Compared With Older Antiretroviral Regimens: A Prospective Multicenter Cohort of Adherence Patterns and HIV-RNA Replication.
- Source :
- Open Forum Infectious Diseases; Jul2021, Vol. 8 Issue 7, p1-8, 8p
- Publication Year :
- 2021
-
Abstract
- Background For many people with HIV (PWH), taking antiretroviral therapy (ARV) every day is difficult. Methods Average adherence (Av-Adh) and log-transformed treatment interruption (TI) to ARV were prospectively measured over 6 months using electronic drug monitoring (EDM) in several cohorts of PWH. Multivariate linear regression models including baseline confounders explored the influence of EDM-defined adherence (R <superscript>2</superscript>) on 6-month log<subscript>10</subscript> HIV-RNA. Multivariate logistic regression models were used to compare the risk of HIV-RNA detection (VR) within subgroups stratified by lower (≤95%) and higher (>95%) Av-Adh. Results Three hundred ninety-nine PWH were analyzed with different ARVs: dolutegravir (n = 102), raltegravir (n = 90), boosted PI (bPI; n = 107), and NNRTI (n = 100). In the dolutegravir group, the influence of adherence pattern measures on R <superscript>2</superscript> for HIV-RNA levels was marginal (+2%). Av-Adh, TI, and Av-Adh × TI increased the R <superscript>2</superscript> for HIV-RNA levels by 54% and 40% in the raltegravir and bPI treatment groups, respectively. TI increased the R <superscript>2</superscript> for HIV-RNA levels by 36% in the NNRTI treatment group. Compared with the dolutegravir-based regimen, the risk of VR was significantly increased for raltegravir (adjusted odds ratio [aOR], 45.6; 95% CI, 4.5–462.1; P =.001), NNRTIs (aOR, 24.8; 95% CI, 2.7–228.4; P =.005), and bPIs (aOR, 28.3; 95% CI, 3.4–239.4; P =.002) in PWH with Av-Adh ≤95%. Among PWH with >95% Av-Adh, there were no significant differences in the risk of VR among the different ARVs. Conclusions These findings support the concept that dolutegravir in combination with 2 other active ARVs achieves greater virological suppression than older ARVs, including raltegravir, NNRTI, and bPI, among PWH with lower adherence. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 23288957
- Volume :
- 8
- Issue :
- 7
- Database :
- Complementary Index
- Journal :
- Open Forum Infectious Diseases
- Publication Type :
- Academic Journal
- Accession number :
- 151803567
- Full Text :
- https://doi.org/10.1093/ofid/ofab316