[Analysis of the causes and predictive factors for discontinuing treatment with tenofovir in pretreated HIV patients]. / Análisis de las causas y factores predictivos de discontinuación del tratamiento con tenofovir en pacientes VIH pretratados.

OBJECTIVE: To determine the frequency and causes for discontinuing treatment with tenofovir and analyse possible predictive factors for changing this therapy in pretreated HIV patients. METHOD: A multi-centre, observational and retrospective study of all HIV patients undergoing treatment with tenofovir between July 2002 and December 2005. Data were obtained from databases for outpatients attending the three pharmacy departments participating in the study, and by reviewing clinical histories. The main sociodemographic, clinical and analytical variables at the start of treatment with tenofovir were collected. The causes for discontinuing treatment were classified as follows: adverse effects, virological failure, death and "other causes". A survival analysis was performed using the Kaplan-Meier method to analyse the possible predictive factors for discontinuing treatment. RESULTS: A total of 733 patients were included in the study and the median treatment period was 34.7 months. A total of 23.8% of patients discontinued treatment for the following reasons: adverse effects (43.2%), death (17.7%), virological failure (14.8%) and "other causes" (24.4%). There were 99 cases of lost to follow-up. In the survival analysis an association was found between normal serum creatinine values (p = 0.0042) at the start of treatment and the statistically significant probability of discontinuing treatment. CONCLUSIONS: Almost a quarter of the patients discontinued treatment with tenofovir during the study. The main cause for this was adverse effects. No association was found between any abnormal basal analytical parameter and a greater probability of discontinuing treatment.

Análisis de las causas y factores predictivos de discontinuación del tratamiento con tenofovir en pacientes VIH pretratados / No disponible

Objetivo: Determinar la frecuencia y las causas de discontinuacióndel tratamiento con tenofovir y analizar los posibles factorespredictores de cambio de esta terapia en pacientes VIHpretratados.Método: Estudio multicéntrico, observacional y retrospectivode todos los pacientes VIH en tratamiento con tenofovir entrejulio-2002 y diciembre-2005. Los datos fueron obtenidos a travésde las bases de datos de pacientes externos de los tres servicios defarmacia participantes y de la revisión de las historias clínicas. Serecogieron las principales variables sociodemográficas, clínicas yanalíticas al inicio del tratamiento con tenofovir. Las causas de discontinuaciónse clasificaron en: efectos adversos, fracaso virológico,exitus y “otras causas”. Se realizó un análisis de supervivenciade Kaplan-Meier para analizar los posibles factores predictores dediscontinuación.Resultados: Un total de 733 pacientes se incluyeron en elestudio. La mediana de tiempo en tratamiento fue de 34,7meses. El 23,8% de los sujetos discontinuó el tratamiento. Lascausas fueron: efectos adversos: 43,2%, exitus: 17,7%, fracasovirológico: 14,8% y “otros motivos”: 24,4%. Hubo 99 casos deperdida de seguimiento. En el análisis de supervivencia, se asociótener niveles normales de creatinina sérica (p = 0,0042) alinicio del tratamiento con probabilidad estadisticamente significativade discontinuación.Conclusiones: Durante el estudio, casi una cuarta parte delos pacientes discontinuó el tratamiento con tenofovir. La principalcausa de discontinuación fueron los efectos adversos. No seasoció ningún parametro analítico basal anormal a mayor probabilidadde discontinuación de tratamiento

Objective: To determine the frequency and causes for discontinuingtreatment with tenofovir and analyse possible predictivefactors for changing this therapy in pretreated HIV patients.Method: A multi-centre, observational and retrospectivestudy of all HIV patients undergoing treatment with tenofovirbetween July 2002 and December 2005. Data were obtainedfrom databases for outpatients attending the three pharmacydepartments participating in the study, and by reviewing clinicalhistories. The main sociodemographic, clinical and analyticalvariables at the start of treatment with tenofovir were collected.The causes for discontinuing treatment were classified as follows:adverse effects, virological failure, death and “other causes”.A survival analysis was performed using the Kaplan-Meiermethod to analyse the possible predictive factors for discontinuingtreatment.Results: A total of 733 patients were included in the studyand the median treatment period was 34.7 months. A total of23.8% of patients discontinued treatment for the following reasons:adverse effects (43.2%), death (17.7%), virological failure(14.8%) and “other causes” (24.4%). There were 99 cases of lostto follow-up. In the survival analysis an association was foundbetween normal serum creatinine values (p = 0.0042) at the startof treatment and the statistically significant probability of discontinuingtreatment.Conclusions: Almost a quarter of the patients discontinuedtreatment with tenofovir during the study. The main cause for thiswas adverse effects. No association was found between anyabnormal basal analytical parameter and a greater probability ofdiscontinuing treatment