Modification of first-line antiretroviral therapy in treatment-naive, HIV positive patients

Smita Shenoy, Dhairya Shrivastava, Chaithanya Malalur, Muralidhar Varma, Sushil Kiran Kunder, Avinash Arivazhahan, Kavitha Saravu

Research output: Contribution to journalArticle

Abstract

Introduction: Modification of initial Antiretroviral Therapy (ART) program is an important issue in HIV infected patients as the number of ART regimens available is limited. Hence, there is a need to understand the factors that affect modification and therefore, the durability of the initial antiretroviral regimen. Aim: To study the type of modification of first line ART in treatment-naïve HIV positive patients and factors influencing it. Materials and Methods: A retrospective observational study was carried out in the HIV clinic of a tertiary care hospital, using data obtained from the case records of the subjects who were initiated on ART between January 2012 to December 2014. Data on baseline patient characteristics, proportion of patients who required modification, type and time of modification was collected. The determinants of time to modification were analysed using Chi-square test. Binomial logistic regression was utilized to assess independent risk factors for change in regimen. Results: Out of 200 case records analysed, 54 patients had to undergo a modification in their initial regimen. The mean age of patients was 44.68 ± 11.31 years. Majority of the patients were males. The most common reason for modification was Adverse Drug Reactions (ADRs) (79.63%) followed by treatment failure (9.25%). In 85.18% cases, modification involved substitution. Occurrence of ADRs and non tenofovir based first-line regimens were associated with higher likelihood of substitution in regimen (p<0.05).The median time (IQR) to modification was 173 (152.25, 293.50) days. Conclusion: ADRs and the use of non tenofovir based regimens resulted in significantly higher rates of modification of antiretroviral therapy. There should be monitoring of patients on ART to detect ADRs at the earliest and increased use of single tablet containing tenofovir based regimen to improve durability of first line regimens.

Original languageEnglish
Pages (from-to)FC01-FC05
JournalJournal of Clinical and Diagnostic Research
Volume11
Issue number10
DOIs
Publication statusPublished - 01-10-2017

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Tenofovir
HIV
Drug-Related Side Effects and Adverse Reactions
Pharmaceutical Preparations
Durability
Substitution reactions
Therapeutics
Tablets
Logistics
Physiologic Monitoring
Tertiary Healthcare
Chi-Square Distribution
Monitoring
Treatment Failure
Tertiary Care Centers
Observational Studies
Retrospective Studies
Logistic Models

All Science Journal Classification (ASJC) codes

  • Clinical Biochemistry

Cite this

Shenoy, Smita ; Shrivastava, Dhairya ; Malalur, Chaithanya ; Varma, Muralidhar ; Kunder, Sushil Kiran ; Arivazhahan, Avinash ; Saravu, Kavitha. / Modification of first-line antiretroviral therapy in treatment-naive, HIV positive patients. In: Journal of Clinical and Diagnostic Research. 2017 ; Vol. 11, No. 10. pp. FC01-FC05.
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abstract = "Introduction: Modification of initial Antiretroviral Therapy (ART) program is an important issue in HIV infected patients as the number of ART regimens available is limited. Hence, there is a need to understand the factors that affect modification and therefore, the durability of the initial antiretroviral regimen. Aim: To study the type of modification of first line ART in treatment-na{\"i}ve HIV positive patients and factors influencing it. Materials and Methods: A retrospective observational study was carried out in the HIV clinic of a tertiary care hospital, using data obtained from the case records of the subjects who were initiated on ART between January 2012 to December 2014. Data on baseline patient characteristics, proportion of patients who required modification, type and time of modification was collected. The determinants of time to modification were analysed using Chi-square test. Binomial logistic regression was utilized to assess independent risk factors for change in regimen. Results: Out of 200 case records analysed, 54 patients had to undergo a modification in their initial regimen. The mean age of patients was 44.68 ± 11.31 years. Majority of the patients were males. The most common reason for modification was Adverse Drug Reactions (ADRs) (79.63{\%}) followed by treatment failure (9.25{\%}). In 85.18{\%} cases, modification involved substitution. Occurrence of ADRs and non tenofovir based first-line regimens were associated with higher likelihood of substitution in regimen (p<0.05).The median time (IQR) to modification was 173 (152.25, 293.50) days. Conclusion: ADRs and the use of non tenofovir based regimens resulted in significantly higher rates of modification of antiretroviral therapy. There should be monitoring of patients on ART to detect ADRs at the earliest and increased use of single tablet containing tenofovir based regimen to improve durability of first line regimens.",
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Modification of first-line antiretroviral therapy in treatment-naive, HIV positive patients. / Shenoy, Smita; Shrivastava, Dhairya; Malalur, Chaithanya; Varma, Muralidhar; Kunder, Sushil Kiran; Arivazhahan, Avinash; Saravu, Kavitha.

In: Journal of Clinical and Diagnostic Research, Vol. 11, No. 10, 01.10.2017, p. FC01-FC05.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Modification of first-line antiretroviral therapy in treatment-naive, HIV positive patients

AU - Shenoy, Smita

AU - Shrivastava, Dhairya

AU - Malalur, Chaithanya

AU - Varma, Muralidhar

AU - Kunder, Sushil Kiran

AU - Arivazhahan, Avinash

AU - Saravu, Kavitha

PY - 2017/10/1

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N2 - Introduction: Modification of initial Antiretroviral Therapy (ART) program is an important issue in HIV infected patients as the number of ART regimens available is limited. Hence, there is a need to understand the factors that affect modification and therefore, the durability of the initial antiretroviral regimen. Aim: To study the type of modification of first line ART in treatment-naïve HIV positive patients and factors influencing it. Materials and Methods: A retrospective observational study was carried out in the HIV clinic of a tertiary care hospital, using data obtained from the case records of the subjects who were initiated on ART between January 2012 to December 2014. Data on baseline patient characteristics, proportion of patients who required modification, type and time of modification was collected. The determinants of time to modification were analysed using Chi-square test. Binomial logistic regression was utilized to assess independent risk factors for change in regimen. Results: Out of 200 case records analysed, 54 patients had to undergo a modification in their initial regimen. The mean age of patients was 44.68 ± 11.31 years. Majority of the patients were males. The most common reason for modification was Adverse Drug Reactions (ADRs) (79.63%) followed by treatment failure (9.25%). In 85.18% cases, modification involved substitution. Occurrence of ADRs and non tenofovir based first-line regimens were associated with higher likelihood of substitution in regimen (p<0.05).The median time (IQR) to modification was 173 (152.25, 293.50) days. Conclusion: ADRs and the use of non tenofovir based regimens resulted in significantly higher rates of modification of antiretroviral therapy. There should be monitoring of patients on ART to detect ADRs at the earliest and increased use of single tablet containing tenofovir based regimen to improve durability of first line regimens.

AB - Introduction: Modification of initial Antiretroviral Therapy (ART) program is an important issue in HIV infected patients as the number of ART regimens available is limited. Hence, there is a need to understand the factors that affect modification and therefore, the durability of the initial antiretroviral regimen. Aim: To study the type of modification of first line ART in treatment-naïve HIV positive patients and factors influencing it. Materials and Methods: A retrospective observational study was carried out in the HIV clinic of a tertiary care hospital, using data obtained from the case records of the subjects who were initiated on ART between January 2012 to December 2014. Data on baseline patient characteristics, proportion of patients who required modification, type and time of modification was collected. The determinants of time to modification were analysed using Chi-square test. Binomial logistic regression was utilized to assess independent risk factors for change in regimen. Results: Out of 200 case records analysed, 54 patients had to undergo a modification in their initial regimen. The mean age of patients was 44.68 ± 11.31 years. Majority of the patients were males. The most common reason for modification was Adverse Drug Reactions (ADRs) (79.63%) followed by treatment failure (9.25%). In 85.18% cases, modification involved substitution. Occurrence of ADRs and non tenofovir based first-line regimens were associated with higher likelihood of substitution in regimen (p<0.05).The median time (IQR) to modification was 173 (152.25, 293.50) days. Conclusion: ADRs and the use of non tenofovir based regimens resulted in significantly higher rates of modification of antiretroviral therapy. There should be monitoring of patients on ART to detect ADRs at the earliest and increased use of single tablet containing tenofovir based regimen to improve durability of first line regimens.

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