ABSTRACT
OBJETIVES: The main objective was to compare the persistence between dolutegravir/lamivudine (DTG/3TC) and bictegravir/emtricitabine/tenofovir-alafenamide (BIC/FTC/TAF) and to analyze reasons for discontinuation. METHODS: We conducted a retrospective, non-interventional, descriptive, and longitudinal study. All human immunodeficiency virus (HIV) patients over 18â¯years treated with DTG/3TC or BIC/FTC/TAF in our center were included. Persistence after first year was compared using the χ2 test. Kaplan-Meier survival analysis was performed. RESULTS: Three hundred fifty-eight patients were included. 99.5% versus 90.99% of patients were persistent after the first year for DTG/3TC and BIC/FTC/TAF respectively (p=.001). Persistence with DGT/3TC was 1237â¯days (IC95% 1216-1258) and persistence with BIC/FTC/TAF was 986â¯days [(IC95% 950-1021); p<.001]. The difference was remained after adjusting for covariates with the cox regression model [HR=8.2 (IC95% 1.03-64.9), p=.047]. The main reasons for discontinuation for BIC/FTC/TAF were toxicity/tolerability. CONCLUSION: In our study, patients have a high persistence. Patients on DTG/3TC treatment are more persistent compared to BIC/FTC/TAF, although BIC/FTC/TAF have worse baseline characteristics. The main reason for discontinuation of BIC/FTC/TAF is tolerability/toxicity.
Subject(s)
Anti-HIV Agents , Emtricitabine , HIV Infections , Heterocyclic Compounds, 3-Ring , Lamivudine , Oxazines , Piperazines , Pyridones , Tenofovir , Humans , HIV Infections/drug therapy , Retrospective Studies , Male , Pyridones/therapeutic use , Female , Lamivudine/therapeutic use , Piperazines/therapeutic use , Oxazines/therapeutic use , Heterocyclic Compounds, 3-Ring/therapeutic use , Heterocyclic Compounds, 3-Ring/adverse effects , Adult , Middle Aged , Anti-HIV Agents/therapeutic use , Emtricitabine/therapeutic use , Tenofovir/therapeutic use , Alanine/therapeutic use , Alanine/analogs & derivatives , Longitudinal Studies , Drug Combinations , Amides/therapeutic use , Heterocyclic Compounds, 4 or More Rings/therapeutic use , Heterocyclic Compounds, 4 or More Rings/adverse effects , Adenine/analogs & derivatives , Adenine/therapeutic useABSTRACT
OBJETIVES: The main objective was to compare the persistence between dolutegravir/lamivudine (DTG/3TC) and bictegravir/emtricitabine/tenofovir-alafenamide (BIC/FTC/TAF) and to analyze reasons for discontinuation. METHODS: We conducted a retrospective, non-interventional, descriptive and longitudinal study. All human immunodeficiency virus (HIV) patients over 18 years treated with DTG/3TC or BIC/FTC/TAF in our center were included. Persistence after first year was compared using the χ2 test. Kaplan-Meier survival analysis was performed. RESULTS: Three hundred fifty-eight patients were included. 99.5% versus 90.99% of patients were persistent after the first year for DTG/3TC and BIC/FTC/TAF respectively (pâ¯=â¯0.001). Persistence with DGT/3TC was 1,237 days (IC95% 1,216-1,258) and persistence with BIC/FTC/TAF was 986 days ([IC95% 950-1,021]; pâ¯<â¯0.001). The difference was remained after adjusting for covariates with the cox regression model (HR= 8.2 [IC95% 1.03-64.9], pâ¯=â¯0.047). The main reasons for discontinuation for BIC/FTC/TAF were toxicity/tolerability. CONCLUSION: In our study patients had a high persistence. Patients on DTG/3TC treatment were more persistent compared to BIC/FTC/TAF, although BIC/FTC/TAF have worse baseline characteristics. The main reason for discontinuation of BIC/FTC/TAF was tolerability/toxicity.
Subject(s)
Anti-HIV Agents , HIV Infections , Heterocyclic Compounds, 3-Ring , Lamivudine , Oxazines , Piperazines , Pyridones , Humans , Retrospective Studies , HIV Infections/drug therapy , Male , Female , Pyridones/therapeutic use , Lamivudine/therapeutic use , Oxazines/therapeutic use , Adult , Heterocyclic Compounds, 3-Ring/therapeutic use , Heterocyclic Compounds, 3-Ring/adverse effects , Piperazines/therapeutic use , Middle Aged , Anti-HIV Agents/therapeutic use , Tenofovir/therapeutic use , Emtricitabine/therapeutic use , Longitudinal Studies , Alanine/therapeutic use , Alanine/analogs & derivatives , Amides/therapeutic use , Drug CombinationsABSTRACT
We present a case of obstructive jaundice due to duodenal amyloidosis presenting as a bulbar pseudotumor (amyloidoma). The duodenal and biliary obstruction were treated by double bypass, hepatojejunostomy and gastroenterostomy. Our case suggests that surgical palliative treatment may be effective, and that anastomosis is probably safe, allowing the patient a good quality of life.
Subject(s)
Amyloidosis/complications , Duodenal Diseases/complications , Jaundice, Obstructive/etiology , Aged , Amyloidosis/diagnosis , Amyloidosis/psychology , Amyloidosis/surgery , Cholecystectomy , Combined Modality Therapy , Disease Progression , Duodenal Diseases/diagnosis , Duodenal Diseases/surgery , Fatal Outcome , Gastroenterostomy , Humans , Jaundice, Obstructive/surgery , Jaundice, Obstructive/therapy , Liver/surgery , Male , Palliative Care , Parenteral Nutrition, Total , Protein-Energy Malnutrition/etiology , Quality of LifeABSTRACT
Presentamos un caso clínico de amiloidosis duodenal que se inició como seudotumor (amiloidoma) de localización bulbar, produciendo ictericia obstructiva. Su tratamiento fue quirúrgico, mediante doble derivación biliodigestiva. Esta técnica fue segura y permitió la paliación de la enfermedad con buena calidad de vida
We present a case of obstructive jaundice due to duodenal amyloidosis presenting as a bulbar pseudotumor (amyloidoma). The duodenal and biliary obstruction were treated by double bypass, hepatojejunostomy and gastroenterostomy. Our case suggests that surgical palliative treatment may be effective, and that anastomosis is probably safe, allowing the patient a good quality of life
