Nevirapine and tuberculosis predict first-line treatment failure in HIV patients in Indonesia: Case-control study

e19070 Background: The results of the ISEL study in non-small cell lung cancer (NSCLC) suggest greater benefit of gefitinib among Asian patients and non-smokers compared with the overall trial population. Methods: We conducted a retrospective case-control study to compare outcomes for gefitinib versus platinum doublet chemotherapy as first line treatment in selected NSCLC patients (stage IIIB/IV adenocarcinoma, PS 0–2). Patient receiving platinum chemotherapy were selected on the basis of disease stage (IIIB or IV), gender, smoking history, WHO performance status (PS) (0–1, or 2) and age (< 60ys or ≥ 60ys) being matched to patients receiving gefitinib. Gefitinib and chemotherapy arm patients were selected by 1:2 ratio in order to increase statistical power. The study was approved by local institute review board. Results: 99 chemo-naïve adenocarcinoma patients treated in our institute from January 2006 to December 2007 were collected: 33 received gefitinib and 66 received chemotherapy. The baseline characteristics are listed in table 1 . The median duration of follow-up was 10 months. Patients receiving gefitinib experienced significantly higher ORR and DCR, and prolonged PFS ( table 1 ). Patients receiving chemotherapy experienced more frequent grade 3–4 neutropenia (42.4% vs 0%), thrombocytopenia (21.2% Vs 0%), febrile neutropenia (7.5% vs 0%) and nausea (24.2% vs 3.0%). The most commonly recorded adverse events in the gefitinib arm were rash/acne (9.1%), diarrhea (3.0%), nausea (3.0%) and anemia (3.0%). Conclusions: The limitations of case-control studies are acknowledged, yet these results were supported by IPASS. Gefitinib as first-line treatment confers clinically relevant benefit in Asian NSCLC patients with adenocarcinoma histology versus platinum based chemotherapy. [Table: see text] [Table: see text]

Download Full-text

Factors associated with first-line antiretroviral treatment failure in adult HIV-positive patients: a case-control study from Ethiopia

BMC Infectious Diseases ◽

10.1186/s12879-019-4170-5 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 5

Author(s):

Yihienew Mequanint Bezabih ◽

Fekadu Beyene ◽

Woldesellassie M. Bezabhe

Keyword(s):

Treatment Failure ◽

Antiretroviral Treatment ◽

Case Control Study ◽

Case Control ◽

Hiv Positive ◽

First Line ◽

Factors Associated ◽

Antiretroviral Treatment Failure ◽

Control Study

Download Full-text

Determinants of first line antiretroviral therapy treatment failure among adult patients on ART at central Ethiopia: un-matched case control study

BMC Infectious Diseases ◽

10.1186/s12879-019-4651-6 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 4

Author(s):

Diriba Mulisa ◽

Mulugeta Tesfa ◽

Getachew Mullu Kassa ◽

Tadesse Tolossa

Keyword(s):

Logistic Regression ◽

Treatment Failure ◽

Case Control Study ◽

Case Control ◽

First Line ◽

Matched Case ◽

Lost To Follow Up ◽

Matched Case Control Study ◽

Control Study

Abstract Background In 2018 in Ethiopia, magnitude of human immunodeficiency virus Acquired Immunodeficiency Syndrome treatment failure was 15.9% and currently the number of patient receiving second line antiretroviral therapy (ART) is more increasing than those taking first line ART. Little is known about the predictors of treatment failure in the study area. Therefore; more factors that can be risk for first line ART failure have to identified to make the patients stay on first line ART for long times. Consequently, the aim of this study was to identify determinants of first line ART treatment failure among patients on ART at St. Luke referral hospital and Tulubolo General Hospital, 2019. Methods A 1:2 un-matched case-control study was conducted among adult patients on active follow up. One new group variables was formed as group 1 for cases and group 0 for controls and then data was entered in to Epi data version 3 and exported to STATA SE version 14 for analysis. From binary logistic regression variables with p value ≤0.25 were a candidate for multiple logistic regression. At the end variables with a p-value ≤0.05 were considered as statistically significant. Result A total of 350 (117 cases and 233 controls) patients were participated in the study. Starting ART after 2 years of being confirmed HIV positive (AOR = 3.82 95% CI 1.37,10.6), nevirapine (NVP) based initial ART (AOR = 2.77,95%CI 1.22,6.28) having history of lost to follow up (AOR 3.66,95%CI 1.44,9.27) and base line opportunistic infection (AOR = 1.97,95%CI 1.06,3.63), staying on first line ART for greater than 5 years (AOR = 3.42,95%CI 1.63,7.19) and CD4 less than100cell/ul (AOR = 2.72,95%CI 1.46,5.07) were independent determinants of first line ART treatment failure. Conclusion Lost to follow up, staying on first line ART for greater than 5 years, presence of opportunistic infections, NVP based NNRT, late initiation of ART are determinant factors for first line ART treatment failure. The concerned bodies have to focus and act on those identified factors to maintain the patient on first line ART.

Download Full-text

Determinants of First Line Antiretroviral Treatment Failure among Patients on Highly Active Antiretroviral Therapy in selected Public Hospitals Jimma, Southwest Ethiopia a Case Control Study

10.21203/rs.2.11281/v1 ◽

2019 ◽

Author(s):

Amrachu Bekele Asfaw ◽

Aderajew Nigusie Tekelehaimanot ◽

Tamirat Shewanew ◽

Esayas Kebede Gudina ◽

Masrie Getnet ◽

...

Keyword(s):

Treatment Failure ◽

Treatment Adherence ◽

Case Control Study ◽

Case Control ◽

Public Hospitals ◽

Urban Resident ◽

First Line ◽

Southwest Ethiopia ◽

Poor Treatment ◽

Control Study

Abstract Background: Identifying determinant factors of antiretroviral therapy (ART) treatment failure are crucial to achieving 90-90-90 treatment target to help end AIDS epidemic by 2020. However, evidences on determinants of first line ART failure in Ethiopia are limited. Hence, the aim of this study was to assess determinants of first line ART failure among patients attending ART care in selected Public Hospitals Jimma, Southwest Ethiopia. Methods: A case control study was conducted in March 2018 on sample of 384(288 controls and 96 cases) adult people living with HIV/AIDS (PLWHA). All available cases were enrolled in the study whereas controls were selected using simple random sampling. Cases were HIV patients aged 15 years or older who were on first line ART regimen with documented treatment failure (virologic, immunologic or clinical). Controls were HIV patients aged 15 years or older who were on first line ART regimen but without evidence of therapeutic failure. Data was extracted from electronic database and supplemented by data collected through interviewer administered questionnaire. Bivariate and Multivariate logistic regression analyses were used. Adjusted odds ratios and 95% confidence interval were used to report independently associated factors with the first line ART failure at P-value<0.05. Results: Median ages of cases and controls were 28 (IQR 25-32) and 27 (IQR23-33), respectively. Being urban resident (AOR:2.2; 95%CI: 1.1, 3.6), smoking (AOR:5.9; 95%CI:3.2, 10.8), Khat use (AOR:2.2; 95%CI:1.3,3.7), poor treatment adherence (AOR: 2.2; 95% CI: 1.1,4.5), tuberculosis coinfection (AOR: 3.9; 95% CI:2.2, 6.8), prior exposure to ART (AOR: 3.8; 95% CI:1.7, 8.1), zidovudine based regimen (AOR: 4.8; 95% CI: 2.5,9.0) and median duration on treatment of more than 73 months (AOR:1.9; 95% CI:1.2, 3.3) were independently associated with first line treatment failure. Conclusions: Multiple factors such as being urban resident, TB co-infection, poor treatment adherence, and zidovudine based regiment were independently associated with first line ART failure. Thus, strategies designed to curb the HIV pandemic should focus on these factors, among others, to achieve the ambitious target of ending AIDS pandemic by 2020 set by UNAIDS. Key words: determinants, first line ART failure, HIV/AIDS, Jimma Zone, Public hospitals

Download Full-text