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Uptake and effectiveness of two-drug compared with three-drug antiretroviral regimens among HIV-positive individuals in Europe.

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Authors
Neesgaard, Bastian
Pelchen-Matthews, Annegret
Ryom, Lene
Florence, Eric
Peters, Lars
Roen, Ashley
Svedhem, Veronika
Clarke, Amanda
Benfield, Thomas
Mitsura, Viktar
Moreno, Santiago
Beniowski, Marek
Begovac, Josip
Matulionyte, Raimonda
Trofimova, Tatyana
Elbirt, Daniel
Kundro, Mariana
Vullo, Vincenzo
Behrens, Georg
Staub, Therese
Ragone, Leigh
Vannappagari, Vani
Lundgren, Jens
Mocroft, Amanda
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Issue Date
2019-11

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Citation
Neesgaard B, Pelchen-Matthews A, Ryom L, et al. Uptake and effectiveness of two-drug compared with three-drug antiretroviral regimens among HIV-positive individuals in Europe. AIDS. 2019;33(13):2013–2024. doi:10.1097/QAD.0000000000002320
Abstract
Objective: To assess the use of two-drug antiretroviral regimens (2DR) and virologic and immunologic outcomes compared with three-drug regimens (3DR) in the EuroSIDA cohort. Design: Multicentre, prospective cohort study. Methods: Logistic regression was used to analyse the uptake and outcomes among HIV-positive individuals who started or switched to a 2DR compared with those on a 3DR. Virologic outcomes were assessed on-treatment as the proportion of individuals with controlled viral load (<400 copies/ml), or with a composite modified FDA snapshot endpoint (mFDA), with mFDA success defined as controlled viral load at 6 months or 12 months for individuals with a known viral load, no regimen changes, AIDS or death. Immunologic response was defined as a 100 cells/μl or a 25% increase in CD4 cell counts from baseline. Results: Between 1 July 2010 and 31 December 2016, 423 individuals started or switched to a 2DR (eight antiretroviral-naive) and 4347 started a 3DR (566 naive). Individuals on 2DR tended to have suppressed viral load, higher CD4 cell counts and more comorbidities at baseline compared with those on 3DR. There were no differences in the proportions of individuals who obtained on-treatment or mFDA success, and no significant differences in the adjusted odds ratios for mFDA success or immunologic responses between the 2DR and 3DR groups at 6 months or 12 months. Conclusion: In routine clinical practice, 2DR were largely used for virologically suppressed individuals with higher cumulative exposure to antiretrovirals and comorbidities. Virologic and immunologic outcomes were similar among those on 2DR or 3DR, although confounding by indication cannot be fully excluded due to the observational nature of the study.
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https://insights.ovid.com/pubmed?pmid=31335807
https://journals.lww.com/aidsonline/fulltext/2019/11010/Uptake_and_effectiveness_of_two_drug_compared_with.7.aspx
ae974a485f413a2113503eed53cd6c53
10.1097/QAD.0000000000002320
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English Journal Articles (Peer Reviewed)

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