Research output: Contribution to journal › Article › peer-review
Uptake and effectiveness of two-drug compared with three-drug antiretroviral regimens among HIV-positive individuals in Europe. / Neesgaard, Bastian; Pelchen-Matthews, Annegret; Ryom, Lene; Florence, Eric; Peters, Lars; Roen, Ashley; Svedhem, Veronika; Clarke, Amanda; Benfield, Thomas; Mitsura, Viktar; Moreno, Santiago; Beniowski, Marek; Begovac, Josip; Matulionyte, Raimonda; Trofimova, Tatyana; Elbirt, Daniel; Kundro, Mariana; Vullo, Vincenzo; Behrens, Georg; Staub, Therese; Ragone, Leigh; Vannappagari, Vani; Lundgren, Jens; Mocroft, Amanda.
In: AIDS, Vol. 33, No. 13, 01.11.2019, p. 2013-2024.Research output: Contribution to journal › Article › peer-review
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TY - JOUR
T1 - Uptake and effectiveness of two-drug compared with three-drug antiretroviral regimens among HIV-positive individuals in Europe
AU - Neesgaard, Bastian
AU - Pelchen-Matthews, Annegret
AU - Ryom, Lene
AU - Florence, Eric
AU - Peters, Lars
AU - Roen, Ashley
AU - Svedhem, Veronika
AU - Clarke, Amanda
AU - Benfield, Thomas
AU - Mitsura, Viktar
AU - Moreno, Santiago
AU - Beniowski, Marek
AU - Begovac, Josip
AU - Matulionyte, Raimonda
AU - Trofimova, Tatyana
AU - Elbirt, Daniel
AU - Kundro, Mariana
AU - Vullo, Vincenzo
AU - Behrens, Georg
AU - Staub, Therese
AU - Ragone, Leigh
AU - Vannappagari, Vani
AU - Lundgren, Jens
AU - Mocroft, Amanda
N1 - Publisher Copyright: © 2019 Lippincott Williams and Wilkins. All rights reserved.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Objective:To assess the use of two-drug antiretroviral regimens (2DR) and virologic and immunologic outcomes compared with three-drug regimens (3DR) in the EuroSIDA cohort.Design:Multicentre, prospective cohort study.Methods:Logistic regression was used to analyse the uptake and outcomes among HIV-positive individuals who started or switched to a 2DR compared with those on a 3DR. Virologic outcomes were assessed on-treatment as the proportion of individuals with controlled viral load (<400 copies/ml), or with a composite modified FDA snapshot endpoint (mFDA), with mFDA success defined as controlled viral load at 6 months or 12 months for individuals with a known viral load, no regimen changes, AIDS or death. Immunologic response was defined as a 100 cells/μl or a 25% increase in CD4+ cell counts from baseline.Results:Between 1 July 2010 and 31 December 2016, 423 individuals started or switched to a 2DR (eight antiretroviral-naive) and 4347 started a 3DR (566 naive). Individuals on 2DR tended to have suppressed viral load, higher CD4+ cell counts and more comorbidities at baseline compared with those on 3DR. There were no differences in the proportions of individuals who obtained on-treatment or mFDA success, and no significant differences in the adjusted odds ratios for mFDA success or immunologic responses between the 2DR and 3DR groups at 6 months or 12 months.Conclusion:In routine clinical practice, 2DR were largely used for virologically suppressed individuals with higher cumulative exposure to antiretrovirals and comorbidities. Virologic and immunologic outcomes were similar among those on 2DR or 3DR, although confounding by indication cannot be fully excluded due to the observational nature of the study.
AB - Objective:To assess the use of two-drug antiretroviral regimens (2DR) and virologic and immunologic outcomes compared with three-drug regimens (3DR) in the EuroSIDA cohort.Design:Multicentre, prospective cohort study.Methods:Logistic regression was used to analyse the uptake and outcomes among HIV-positive individuals who started or switched to a 2DR compared with those on a 3DR. Virologic outcomes were assessed on-treatment as the proportion of individuals with controlled viral load (<400 copies/ml), or with a composite modified FDA snapshot endpoint (mFDA), with mFDA success defined as controlled viral load at 6 months or 12 months for individuals with a known viral load, no regimen changes, AIDS or death. Immunologic response was defined as a 100 cells/μl or a 25% increase in CD4+ cell counts from baseline.Results:Between 1 July 2010 and 31 December 2016, 423 individuals started or switched to a 2DR (eight antiretroviral-naive) and 4347 started a 3DR (566 naive). Individuals on 2DR tended to have suppressed viral load, higher CD4+ cell counts and more comorbidities at baseline compared with those on 3DR. There were no differences in the proportions of individuals who obtained on-treatment or mFDA success, and no significant differences in the adjusted odds ratios for mFDA success or immunologic responses between the 2DR and 3DR groups at 6 months or 12 months.Conclusion:In routine clinical practice, 2DR were largely used for virologically suppressed individuals with higher cumulative exposure to antiretrovirals and comorbidities. Virologic and immunologic outcomes were similar among those on 2DR or 3DR, although confounding by indication cannot be fully excluded due to the observational nature of the study.
KW - combination antiretroviral treatment
KW - dual therapy
KW - HIV
KW - nucleot(s)ide reverse transcriptase inhibitor-sparing regimens
KW - simplification
KW - two-drug regimens
UR - http://www.scopus.com/inward/record.url?scp=85072903353&partnerID=8YFLogxK
U2 - 10.1097/QAD.0000000000002320
DO - 10.1097/QAD.0000000000002320
M3 - Article
C2 - 31335807
AN - SCOPUS:85072903353
VL - 33
SP - 2013
EP - 2024
JO - AIDS
JF - AIDS
SN - 0269-9370
IS - 13
ER -
ID: 88746695