TY - JOUR
T1 - Factors Associated with Virological Failure in First-Line Antiretroviral Therapy in Patients Diagnosed with HIV-1 between 2010 and 2018 in Israel
AU - Wagner, Tali
AU - Levy, Itzchak
AU - Elbirt, Daniel
AU - Shahar, Eduardo
AU - Olshtain-Pops, Karen
AU - Elinav, Hila
AU - Chowers, Michal
AU - Istomin, Valery
AU - Riesenberg, Klaris
AU - Geva, Dikla
AU - Zuckerman, Neta S.
AU - Wax, Marina
AU - Shirazi, Rachel
AU - Gozlan, Yael
AU - Matus, Natasha
AU - Girshengorn, Shirley
AU - Marom, Rotem
AU - Mendelson, Ella
AU - Mor, Orna
AU - Turner, Dan
N1 - Publisher Copyright:
© 2023 by the authors.
PY - 2023/12/1
Y1 - 2023/12/1
N2 - Despite the progress in contemporary antiretroviral therapy (ART) and the continuous changes in treatment guidelines, virological failure (VF) is still an ongoing concern. The goal of this study was to assess factors related to VF after first-line ART. A longitudinal cohort retrospective study of individuals on first-line ART diagnosed with HIV-1 in 2010–2018 and followed-up for a median of two years was conducted. Demographics, baseline and longitudinal CD4 counts, treatment regimens, adherence and VF were recorded. The Cox proportional hazards regression and mixed models were used. A cohort of 1130 patients were included. Overall, 80% were males and 62% were Israeli-born individuals. Compared to individuals diagnosed in 2010–2014, when treatment was initiated according to CD4 levels, those diagnosed in 2015–2018 were older and had lower baseline CD4 counts. VF was recorded in 66 (5.8%) patients. Diagnosis with CD4 <200 cells/mmᶟ with AIDS-defining conditions (HR = 2.75, 95%CI:1.52–4.97, p < 0.001) and non-integrase strand transfer inhibitor regimens (non-INSTI, HR = 1.80, 95%CI:1.01–3.24, p = 0.047) increased VF risk. No impact of baseline resistance was observed. We concluded that the early detection of HIV-1 infection and usage of INSTI-based regimens are recommended to reduce VF.
AB - Despite the progress in contemporary antiretroviral therapy (ART) and the continuous changes in treatment guidelines, virological failure (VF) is still an ongoing concern. The goal of this study was to assess factors related to VF after first-line ART. A longitudinal cohort retrospective study of individuals on first-line ART diagnosed with HIV-1 in 2010–2018 and followed-up for a median of two years was conducted. Demographics, baseline and longitudinal CD4 counts, treatment regimens, adherence and VF were recorded. The Cox proportional hazards regression and mixed models were used. A cohort of 1130 patients were included. Overall, 80% were males and 62% were Israeli-born individuals. Compared to individuals diagnosed in 2010–2014, when treatment was initiated according to CD4 levels, those diagnosed in 2015–2018 were older and had lower baseline CD4 counts. VF was recorded in 66 (5.8%) patients. Diagnosis with CD4 <200 cells/mmᶟ with AIDS-defining conditions (HR = 2.75, 95%CI:1.52–4.97, p < 0.001) and non-integrase strand transfer inhibitor regimens (non-INSTI, HR = 1.80, 95%CI:1.01–3.24, p = 0.047) increased VF risk. No impact of baseline resistance was observed. We concluded that the early detection of HIV-1 infection and usage of INSTI-based regimens are recommended to reduce VF.
KW - CD4 trajectory curves
KW - HIV-1
KW - INSTI regimens
KW - adherence
KW - first-line ART
KW - people living with HIV-1 (PLHIV)
KW - virological failure (VF)
UR - http://www.scopus.com/inward/record.url?scp=85180475358&partnerID=8YFLogxK
U2 - 10.3390/v15122439
DO - 10.3390/v15122439
M3 - Article
C2 - 38140680
AN - SCOPUS:85180475358
SN - 1999-4915
VL - 15
JO - Viruses
JF - Viruses
IS - 12
M1 - 2439
ER -