BACKGROUND: Changes in virologic response to initial combination antiretroviral therapy (cART) over calendar time may indicate improvements in cART or emergence of primary resistance. Regional variations may identify differences in available antiretroviral drugs or patient management. METHODS: Virologic response (viral load < 500 copies/mL) 6 to 12 months after starting cART was analyzed in antiretroviral-naive EuroSIDA patients. Analyses were stratified by region (south, central west, north, east) or time started cART (early, 1996-1997; mid, 1998-1999; late, 2000-1904). RESULTS: Virologic suppression was achieved by 60% of 2102 patients: 57% south (n = 560), 61% central west (n = 466), 63% north (n = 606), 58% east (n = 470) (P = 0.091). An increase was observed over time: 52% early cART, 56% mid cART, 69% late cART (P < 0.001). Overall, there were significant effects of region (P = 0.026) and time (P < 0.001) on virologic response after adjustment for confounders. Stratified by period, regional differences were less evident (early cART, P = 0.967; mid cART, P = 0.291; late cART, P = 0.163). Stratified by region, temporal changes were observed (south, P = 0.061; central west, P < 0.001; north: P = 0.070; east, P = 0.001). CONCLUSIONS: There was some evidence of regional differences in initial virologic response to cART. Improvements over time were observed, suggesting that so far, the effect of primary resistance has not been of sufficient magnitude to prevent increasing suppression rates.
BACKGROUND: Changes in virologic response to initial combination antiretroviral therapy (cART) over calendar time may indicate improvements in cART or emergence of primary resistance. Regional variations may identify differences in available antiretroviral drugs or patient management. METHODS: Virologic response (viral load < 500 copies/mL) 6 to 12 months after starting cART was analyzed in antiretroviral-naive EuroSIDA patients. Analyses were stratified by region (south, central west, north, east) or time started cART (early, 1996-1997; mid, 1998-1999; late, 2000-1904). RESULTS: Virologic suppression was achieved by 60% of 2102 patients: 57% south (n = 560), 61% central west (n = 466), 63% north (n = 606), 58% east (n = 470) (P = 0.091). An increase was observed over time: 52% early cART, 56% mid cART, 69% late cART (P < 0.001). Overall, there were significant effects of region (P = 0.026) and time (P < 0.001) on virologic response after adjustment for confounders. Stratified by period, regional differences were less evident (early cART, P = 0.967; mid cART, P = 0.291; late cART, P = 0.163). Stratified by region, temporal changes were observed (south, P = 0.061; central west, P < 0.001; north: P = 0.070; east, P = 0.001). CONCLUSIONS: There was some evidence of regional differences in initial virologic response to cART. Improvements over time were observed, suggesting that so far, the effect of primary resistance has not been of sufficient magnitude to prevent increasing suppression rates.
Authors: Alison G Abraham; Bryan Lau; Steven Deeks; Richard D Moore; Jinbing Zhang; Joseph Eron; Richard Harrigan; M John Gill; Mari Kitahata; Marina Klein; Sonia Napravnik; Anita Rachlis; Benigno Rodriguez; Sean Rourke; Constance Benson; Ron Bosch; Ann Collier; Kelly Gebo; James Goedert; Robert Hogg; Michael Horberg; Lisa Jacobson; Amy Justice; Greg Kirk; Jeff Martin; Rosemary McKaig; Michael Silverberg; Timothy Sterling; Jennifer Thorne; James Willig; Stephen J Gange Journal: Am J Epidemiol Date: 2011-08-03 Impact factor: 4.897
Authors: A Mocroft; P Reiss; A Rakhmanova; D Banhegyi; A N Phillips; S De Wit; M Ristola; J D Lundgren; J Grarup; O Kirk Journal: Infection Date: 2014-06-06 Impact factor: 3.553
Authors: Ann K Sullivan; Dorthe Raben; Joanne Reekie; Michael Rayment; Amanda Mocroft; Stefan Esser; Agathe Leon; Josip Begovac; Kees Brinkman; Robert Zangerle; Anna Grzeszczuk; Anna Vassilenko; Vesna Hadziosmanovic; Maksym Krasnov; Anders Sönnerborg; Nathan Clumeck; José Gatell; Brian Gazzard; Antonella d'Arminio Monforte; Jürgen Rockstroh; Jens D Lundgren Journal: PLoS One Date: 2013-01-15 Impact factor: 3.240
Authors: D Raben; A Mocroft; M Rayment; V M Mitsura; V Hadziosmanovic; Z M Sthoeger; A Palfreeman; S Morris; G Kutsyna; A Vassilenko; J Minton; C Necsoi; V P Estrada; A Grzeszczuk; V Svedhem Johansson; J Begovac; E L C Ong; A Cabié; F Ajana; B M Celesia; F Maltez; M Kitchen; L Comi; U B Dragsted; N Clumeck; J Gatell; B Gazzard; A d'Arminio Monforte; J Rockstroh; Y Yazdanpanah; K Champenois; M L Jakobsen; A Sullivan; J D Lundgren Journal: PLoS One Date: 2015-11-11 Impact factor: 3.240
Authors: Barbara Castelnuovo; Agnes Kiragga; Joseph Musaazi; Joseph Sempa; Frank Mubiru; Jane Wanyama; Bonnie Wandera; Moses Robert Kamya; Andrew Kambugu Journal: PLoS One Date: 2015-12-07 Impact factor: 3.240