004.4 Pill dumping in adolescents receiving a boosted protease inhibitor regimen as part of second-line antiretroviral therapy: experiences from an urban HIV clinic

Abstract We compared viral suppression rates between patients who continued tenofovir disoproxil fumarate (TDF)/lamivudine (3TC) vs switched to zidovudine (ZDV)/3TC in combination with a boosted protease inhibitor after failure of first-line efavirenz/TDF/3TC. We found higher rates of viral suppression with continued TDF/3TC compared with switching to ZDV/3TC.

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Longer-term effectiveness of protease-inhibitor-based second line antiretroviral therapy in four large sub-Saharan African clinics

Journal of Infection ◽

10.1016/j.jinf.2019.03.003 ◽

2019 ◽

Vol 78 (5) ◽

pp. 402-408

Author(s):

Fred S. Sarfo ◽

Barbara Castelnuovo ◽

Iuri Fanti ◽

Torsten Feldt ◽

Francesca Incardona ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Protease Inhibitor ◽

Second Line ◽

Sub Saharan ◽

Second Line Antiretroviral Therapy

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Virologic Failure of Protease Inhibitor-Based Second-Line Antiretroviral Therapy without Resistance in a Large HIV Treatment Program in South Africa

PLoS ONE ◽

10.1371/journal.pone.0032144 ◽

2012 ◽

Vol 7 (3) ◽

pp. e32144 ◽

Cited By ~ 40

Author(s):

Julie H. Levison ◽

Catherine Orrell ◽

Sébastien Gallien ◽

Daniel R. Kuritzkes ◽

Naishin Fu ◽

...

Keyword(s):

South Africa ◽

Antiretroviral Therapy ◽

Protease Inhibitor ◽

Treatment Program ◽

Virologic Failure ◽

Hiv Treatment ◽

Second Line ◽

Second Line Antiretroviral Therapy

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A Clinical Prediction Rule for Protease Inhibitor Resistance in Patients Failing Second-Line Antiretroviral Therapy

JAIDS Journal of Acquired Immune Deficiency Syndromes ◽

10.1097/qai.0000000000001923 ◽

2019 ◽

Vol 80 (3) ◽

pp. 325-329 ◽

Cited By ~ 6

Author(s):

Karen Cohen ◽

Annemie Stewart ◽

Andre P. Kengne ◽

Rory Leisegang ◽

Marla Coetsee ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Protease Inhibitor ◽

Prediction Rule ◽

Clinical Prediction Rule ◽

Second Line ◽

Clinical Prediction ◽

Protease Inhibitor Resistance ◽

Inhibitor Resistance ◽

Second Line Antiretroviral Therapy

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Predictors of failure on second-line antiretroviral therapy with protease inhibitor mutations in Uganda

AIDS Research and Therapy ◽

10.1186/s12981-021-00338-y ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Hellen Musana ◽

Jude Thaddeus Ssensamba ◽

Mary Nakafeero ◽

Henry Mugerwa ◽

Flavia Matovu Kiweewa ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Protease Inhibitor ◽

Tuberculosis Treatment ◽

Categorical Variables ◽

Control Analysis ◽

Second Line ◽

Paired Data ◽

Factors Associated ◽

Third Line ◽

Second Line Antiretroviral Therapy

Abstract Introduction Failure on second-line antiretroviral therapy (ART) with protease inhibitor (PI) mutations (VF-M) is on the rise. However, there is a paucity of information on the factors associated with this observation in low-income countries. Knowledge of underlying factors is critical if we are to minimize the number of PLHIV switched to costly third-line ART. Our study investigated the factors associated with VF-M. Methods We conducted a matched case–control analysis of patients' records kept at the Joint Clinical Research Center, starting from January 2008 to May 2018. We matched records of patients who failed the second-line ART with major PI mutations (cases) with records of patients who were virologically suppressed (controls) by a ratio of 1:3. Data analysis was conducted using STATA Version 14. Categorical variables were compared with the outcomes failure on second-line ART with PI mutations using the Chi-square and Fisher's exact tests where appropriate. Conditional logistic regression for paired data was used to assess the association between the outcome and exposure variables, employing the backward model building procedure. Results Of the 340 reviewed patients' records, 53% were women, and 6.2% had previous tuberculosis treatment. Males (aOR = 2.58, [CI 1.42–4.69]), and patients concurrently on tuberculosis treatment while on second-line ART (aOR = 5.65, [CI 1.76–18.09]) had higher odds of VF-M. ART initiation between 2001 and 2015 had lower odds of VF-M relative to initiation before the year 2001. Conclusion Males and patients concomitantly on tuberculosis treatment while on second-line ART are at a higher risk of VF-M. HIV/AIDS response programs should give special attention to this group of people if we are to minimize the need for expensive third-line ART. We recommend more extensive, explorative studies to ascertain underlying factors.

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Clinical laboratory assessment of hepatitis C and HIV coinfected patients according to the antiretroviral therapy received

Revista do Instituto de Medicina Tropical de São Paulo ◽

10.1590/s0036-46652005000100003 ◽

2005 ◽

Vol 47 (1) ◽

pp. 13-17 ◽

Cited By ~ 2

Author(s):

Roberto M. Carrasco Navarro ◽

Maria Cássia Jacintho Mendes-Correa ◽

Norma de Paula Cavalheiro ◽

Antonio Alci Barone

Keyword(s):

Antiretroviral Therapy ◽

Protease Inhibitor ◽

Clinical Laboratory ◽

Descriptive Study ◽

Hepatic Disease ◽

Low Grade ◽

Hepatic Enzyme ◽

Laboratory Assessment ◽

Protease Inhibitor Regimen ◽

Inhibitor Regimen

During the year of 2001, a retrospective, descriptive study in order to determine the influence of the antiretroviral therapy received by 111 HIV-HCV coinfected patients who had undergone at least one liver biopsy was conduced, 74 of them were treated with a protease inhibitor regimen (WPI), and 37 with a non-protease inhibitor regimen (NPI). The main characteristics found were: a young patient population (mean age 41 years old in both groups), composed in most part of male individuals (74.3% WPI and 51.4% NPI) with previous risk factors for both infections (WPI 93.2% and NPI 89.2%). The most significant findings included AIDS-defining disease (WPI 18.9% and NPI 13.5% of the cases), elevated hepatic enzyme levels (WPI: SGOT 52.1 and NPI 53.2), absence of liver disease-related symptoms (16.2% for both groups), average CD4 count > 350 for both groups (WPI 362.2 and NPI 378.1), predominantly low-grade fibrosis in both populations (0-2 in 63.6% of WPI patients and in 80% of NPI patients), with necro-inflammatory activity ranging from 5-7 in 51.3% and 42.9% of WPI patients and NPI patients, respectively. It is suggested a sequential biopsy to better evaluate the evolution of the hepatic disease, according to the HAART regimen received.

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Protease Inhibitor Resistance in the First 3 Years of Second-Line Antiretroviral Therapy for HIV-1 in Sub-Saharan Africa

The Journal of Infectious Diseases ◽

10.1093/infdis/jiw219 ◽

2016 ◽

Vol 214 (6) ◽

pp. 873-883 ◽

Cited By ~ 31

Author(s):

T. Sonia Boender ◽

Raph L. Hamers ◽

Pascale Ondoa ◽

Maureen Wellington ◽

Cleophas Chimbetete ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Protease Inhibitor ◽

Sub Saharan Africa ◽

Second Line ◽

Protease Inhibitor Resistance ◽

Sub Saharan ◽

Inhibitor Resistance ◽

Hiv 1 ◽

Second Line Antiretroviral Therapy

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Predictors of Failure on Second-line Antiretroviral Therapy with Protease Inhibitor Mutations in Uganda

10.21203/rs.3.rs-30512/v1 ◽

2020 ◽

Author(s):

Hellen Musana ◽

Ssensamba Jude Thaddeus ◽

Mary Nakafeero ◽

Henry Mugerwa ◽

Flavia Matovu Kiweewa ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Protease Inhibitor ◽

Tuberculosis Treatment ◽

Categorical Variables ◽

Control Analysis ◽

Second Line ◽

Paired Data ◽

Factors Associated ◽

Third Line ◽

Second Line Antiretroviral Therapy

Abstract Introduction Failure on second-line antiretroviral therapy (ART) with protease inhibitor (PI) mutations is on the rise. However, there is a paucity of information on the factors associated with this observation in the context of low-income countries. Knowledge of underlying factors is key if we are to minimize the number of PLHIV switched to costly third-line ART. Our study investigated the factors associated with failure on second-line ART with PI mutations. Methods We conducted a matched case-control analysis of patients' records kept at the Joint Clinical Research Center, starting from January 2008 to May 2018. We matched records of patients who failed the second-line ART with major PI mutations (cases) with records of patients who were virologically suppressed (controls) by a ratio of 1:3. Data analysis was conducted using STATA Version 14, and descriptive statistics comparing cases and controls were generated. Categorical variables were compared with the outcome, failure on second line ART with PI mutations using the Chi-square and Fisher's exact tests where appropriate. Conditional logistic regression for paired data was used to assess the association between the outcome and exposure variables, employing the backward model building procedure was done. Results Of the 340 reviewed patients' records, 53% were women, and 6.2% had previous Tuberculosis treatment. Males (aOR 2.64 CI: 1.0-4.64), type of second-line ART (aOR 3.92 CI: 1.15-13.38), and Tuberculosis treatment while on second-line ART (aOR7.08 CI: 2.35-21.29) highly predicted failure on second-line ART with PI mutations. Conclusion Males and patients concomitantly on Tuberculosis treatment while on second-line ART are at a higher risk of failing on second-line ART with PI mutations. HIV/AIDS response programs should give special attention to this group of people if we are to minimize the need for expensive third-line ART. More extensive explorative studies to ascertain underlying factors are recommended.

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