Evolution of antiretroviral prescription and response over a period of 8 years: an Italian multicentre observational prospective cohort study.

Abstract:

BACKGROUND:There is very less information on the use of antiretroviral (ARV) drugs and viro-immunological outcome over calendar years in Italy. PATIENTS AND METHODS:We performed an analysis of a prospective observational cohort (MASTER) to assess antiretroviral drug use in first line HAART and explore whether initial treatment response changed over the years. RESULTS:3,648 ARV-naive patients with available HIV-RNA and CD4+ T cell count at baseline who started their first HAART between 1997 and 2004 were studied. Mean age was 37.7 years; they were mostly males (72.3%) and Italians (81.4%). Prescription of non-nucleoside reverse transcriptase inhibitors and protease inhibitors boosted with ritonavir rose from 0.3% in 1997 to 58% in 2004 and from 0.3%in 1997 to 33.4% in 2004, respectively. Virological failures decreased over calendar years: from 42.9% in 1997 to 8.1%in 2004 after 6 months of HAART (p<0.001); from 42.1%(1997) to 10.7% (2004) after 12 months (p<0.001) and; from 39.5% (1997) to 8.2% (2004) after 18 months (p<0.001). The same trend, but less striking, was found for immunological failure rates. CONCLUSIONS:In the general Italian population of HIV-positive patients, evolution of treatment prescription correlated with improved viro-immunological outcome.

journal_name

Infection

journal_title

Infection

authors

Sighinolfi L,Torti C,Zeni C,Ghinelli F,Suter F,Maggiolo F,Antinori A,Antonucci G,Castelnuovo F,Ladisa N,Migliorino M,Novati S,De Luca A,Lo Caputo S,Paraninfo G,Tinelli C,Carosi G,Italian MASTER Database Cohort.

doi

10.1007/s15010-007-7227-0

subject

Has Abstract

pub_date

2008-06-01 00:00:00

pages

244-9

issue

3

eissn

0300-8126

issn

1439-0973

journal_volume

36

pub_type

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