Which antiretrovirals should be prescribed as first-line treatments? Changes over the past 10 years in France.
Adult
Anti-HIV Agents
/ therapeutic use
Anti-Retroviral Agents
/ therapeutic use
Antiretroviral Therapy, Highly Active
/ statistics & numerical data
Cohort Studies
Drug Therapy, Combination
Female
France
/ epidemiology
HIV
HIV Infections
/ drug therapy
HIV Protease Inhibitors
/ therapeutic use
History, 21st Century
Humans
Male
Middle Aged
Practice Patterns, Physicians'
/ history
Reverse Transcriptase Inhibitors
/ therapeutic use
Viral Load
HIV infection
Infection par le VIH
Inhibiteurs d’intégrase
Initial HIV therapy
Integrase strand transfer inhibitors
Traitement antirétroviral initial
Journal
Medecine et maladies infectieuses
ISSN: 1769-6690
Titre abrégé: Med Mal Infect
Pays: France
ID NLM: 0311416
Informations de publication
Date de publication:
Jun 2019
Jun 2019
Historique:
received:
05
04
2017
revised:
18
09
2017
accepted:
12
10
2018
pubmed:
10
11
2018
medline:
28
12
2019
entrez:
10
11
2018
Statut:
ppublish
Résumé
To describe the changes in first-line antiretroviral (ART) regimens in France between 2005 and 2015 and patients' characteristics related to the use of protease inhibitors in 2015. We extracted all patients starting ART between 2005 and 2015 from a large prospective cohort. Regimens were classified as three nucleoside reverse transcriptase inhibitors (NRTI), or two NRTIs with a boosted protease inhibitor (bPI), with a non-nucleoside reverse transcriptase inhibitor (NNRTI), or with an INSTI. Patients' characteristics at the time of initiation were collected. A multinomial logit model was fitted to analyze characteristics related to the choice of regimen in 2015. We analyzed data from 15,897 patients. The proportion of patients starting with (i) a bPI decreased from 60% before 2014 to 38.1% in 2015; (ii) an NNRTI decreased from 30% to 17.8% in 2015; (iii) an INSTI gradually increased to 39.4% in 2015. In 2015, patients with an initial viral load ˃5 log copies/mL were less likely to receive NNRTI (OR=0.08) or INSTI regimens (OR=0.69) than bPIs. Patients with initial CD4 The use of bPI as first-line ART declined sharply in France from 2005 to 2015. bPI remained of preferential use in patients with high viral load, low CD4
Identifiants
pubmed: 30409541
pii: S0399-077X(17)30544-9
doi: 10.1016/j.medmal.2018.10.005
pii:
doi:
Substances chimiques
Anti-HIV Agents
0
Anti-Retroviral Agents
0
HIV Protease Inhibitors
0
Reverse Transcriptase Inhibitors
0
Types de publication
Historical Article
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
264-269Informations de copyright
Copyright © 2018 Elsevier Masson SAS. All rights reserved.