RESUMO
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.
Assuntos
Fármacos Anti-HIV , Emtricitabina , Infecções por HIV , Compostos Heterocíclicos com 3 Anéis , Lamivudina , Oxazinas , Piperazinas , Piridonas , Tenofovir , Humanos , Infecções por HIV/tratamento farmacológico , Estudos Retrospectivos , Masculino , Piridonas/uso terapêutico , Feminino , Lamivudina/uso terapêutico , Piperazinas/uso terapêutico , Oxazinas/uso terapêutico , Compostos Heterocíclicos com 3 Anéis/uso terapêutico , Compostos Heterocíclicos com 3 Anéis/efeitos adversos , Adulto , Pessoa de Meia-Idade , Fármacos Anti-HIV/uso terapêutico , Emtricitabina/uso terapêutico , Tenofovir/uso terapêutico , Alanina/uso terapêutico , Alanina/análogos & derivados , Estudos Longitudinais , Combinação de Medicamentos , Amidas/uso terapêutico , Compostos Heterocíclicos de 4 ou mais Anéis/uso terapêutico , Compostos Heterocíclicos de 4 ou mais Anéis/efeitos adversos , Adenina/análogos & derivados , Adenina/uso terapêuticoRESUMO
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.
Assuntos
Fármacos Anti-HIV , Infecções por HIV , Compostos Heterocíclicos com 3 Anéis , Lamivudina , Oxazinas , Piperazinas , Piridonas , Humanos , Estudos Retrospectivos , Infecções por HIV/tratamento farmacológico , Masculino , Feminino , Piridonas/uso terapêutico , Lamivudina/uso terapêutico , Oxazinas/uso terapêutico , Adulto , Compostos Heterocíclicos com 3 Anéis/uso terapêutico , Compostos Heterocíclicos com 3 Anéis/efeitos adversos , Piperazinas/uso terapêutico , Pessoa de Meia-Idade , Fármacos Anti-HIV/uso terapêutico , Tenofovir/uso terapêutico , Emtricitabina/uso terapêutico , Estudos Longitudinais , Alanina/uso terapêutico , Alanina/análogos & derivados , Amidas/uso terapêutico , Combinação de MedicamentosRESUMO
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.
Assuntos
Amiloidose/complicações , Duodenopatias/complicações , Icterícia Obstrutiva/etiologia , Idoso , Amiloidose/diagnóstico , Amiloidose/psicologia , Amiloidose/cirurgia , Colecistectomia , Terapia Combinada , Progressão da Doença , Duodenopatias/diagnóstico , Duodenopatias/cirurgia , Evolução Fatal , Gastroenterostomia , Humanos , Icterícia Obstrutiva/cirurgia , Icterícia Obstrutiva/terapia , Fígado/cirurgia , Masculino , Cuidados Paliativos , Nutrição Parenteral Total , Desnutrição Proteico-Calórica/etiologia , Qualidade de VidaRESUMO
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
