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Treatment switch guided by HIV-1 genotyping in Brazil
Tupinambás, Unaí; Ribeiro, Flávia Andrade; Aleixo, Agdemir; Greco, Dirceu.
  • Tupinambás, Unaí; Municipal Secretary of Health of Belo Horizonte. Belo Horizonte. BR
  • Ribeiro, Flávia Andrade; s.af
  • Aleixo, Agdemir; s.af
  • Greco, Dirceu; Federal University of Minas Gerais. School of Medicine. Belo Horizonte. BR
Braz. j. infect. dis ; 10(2): 82-88, Apr. 2006. tab, graf
Artigo em Inglês | LILACS | ID: lil-431978
ABSTRACT
We assessed the performance of HIV-1 genotyping tests in rescue therapy. Patients were divided into two groups group 1 (genotyped), included those switching to new antiretroviral drugs based on HIV-1 genotyping data, and group 2 (standard of care -SOC), comprised those in rescue therapy who had not used this test. This was an open and non-randomized study, with 74 patients, followed up for a mean period of 12 months, from February 2002 to May 2003. The groups differed in the duration of antiretroviral use, experience with diverse drug classes (non-nucleoside reverse transcriptase inhibitors and protease inhibitors) and viral load <2.6 log10 copies/mL at any time during treatment. In 23 patients (group 1), the switch in antiretroviral (ARV) regimen was based on genotyping data; this test was not used for 51 patients (group 2). Two CD4 + lymphocyte counts and viral load counts were made for each patient during the study. Data from the pharmacy where patients received antiretroviral agents, medical charts, and direct interviews with patients to assess compliance to treatment, were analyzed. In the genotyped group, the average drop in viral load was 2.8 log10, compared with a 1.5 log10 difference in group 2; the difference was significant in the first assessment performed six months after switching (p=0.001). Considering the patients with viral load < 2.6 log10 (400 copies/mL) after switching, the patients in group 1 had a better performance in the first assessment (73.9 percent versus 31.1 percent in groups 1 and 2, respectively); this difference was significant (p=0.001). In multivariate analysis, the variables associated with a greater drop in viral load in the first assessment were the patients whose switching was based on genotyping (group 1), those with a past history of viral load < 2.6 log10 and correct use of antiretroviral agents. In conclusion, the genotyping test and adherence were found to be independent factors for success in the management of patients who failed treatment.
Assuntos
Texto completo: DisponíveL Índice: LILACS (Américas) Assunto principal: Infecções por HIV / HIV-1 / Fármacos Anti-HIV / Genótipo Tipo de estudo: Ensaio Clínico Controlado / Estudo prognóstico Limite: Adulto / Feminino / Humanos / Masculino País/Região como assunto: América do Sul / Brasil Idioma: Inglês Revista: Braz. j. infect. dis Assunto da revista: Doenças Transmissíveis Ano de publicação: 2006 Tipo de documento: Artigo País de afiliação: Brasil Instituição/País de afiliação: Federal University of Minas Gerais/BR / Municipal Secretary of Health of Belo Horizonte/BR

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Texto completo: DisponíveL Índice: LILACS (Américas) Assunto principal: Infecções por HIV / HIV-1 / Fármacos Anti-HIV / Genótipo Tipo de estudo: Ensaio Clínico Controlado / Estudo prognóstico Limite: Adulto / Feminino / Humanos / Masculino País/Região como assunto: América do Sul / Brasil Idioma: Inglês Revista: Braz. j. infect. dis Assunto da revista: Doenças Transmissíveis Ano de publicação: 2006 Tipo de documento: Artigo País de afiliação: Brasil Instituição/País de afiliação: Federal University of Minas Gerais/BR / Municipal Secretary of Health of Belo Horizonte/BR