TY - JOUR
T1 - Time to virological failure, treatment change and interruption for individuals treated within 12 months of HIV seroconversion and in chronic infection
AU - Zugna, Daniela
AU - Geskus, Ronald B.
AU - de Stavola, Bianca
AU - Rosinska, Magdalena
AU - Bartmeyer, Barbara
AU - Boufassa, Faroudy
AU - Chaix, Marie-Laure
AU - Babiker, Abdel
AU - Porter, Kholoud
AU - AUTHOR GROUP
AU - del Amo, Julia
AU - Meyer, Lawrence
AU - Bucher, Heiner C.
AU - Chêne, Geneviève
AU - Hamouda, Osamah
AU - Pillay, Deenan
AU - Prins, Maria
AU - Rosinska, Magda
AU - Sabin, Caroline
AU - Touloumi, Giota
AU - Olson, Ashley
AU - Coughlin, Kate
AU - Walker, Sarah
AU - de Luca, Andrea
AU - Fisher, Martin
AU - Muga, Robert
AU - Zangerle, Robert
AU - Kelleher, Tony
AU - Cooper, David
AU - Grey, Pat
AU - Finlayson, Robert
AU - Bloch, Mark
AU - Ramacciotti, Tim
AU - Gelgor, Linda
AU - Smith, Don
AU - Gill, John
AU - Lutsar, Irja
AU - Dabis, Francois
AU - Thiebaut, Rodolphe
AU - Masquelier, Bernard
AU - Costagliola, Dominique
AU - Guiguet, Marguerite
AU - Vanhems, Philippe
AU - Ghosn, Jade
AU - Kücherer, Claudia
AU - Paparizos, V.
AU - Gargalianos-Kakolyris, P.
AU - Lazanas, M.
AU - Pantazis, Nikos
AU - van der Helm, Jannie
AU - Schuitemaker, Hanneke
PY - 2012
Y1 - 2012
N2 - Background: Estimates of treatment failure, change and interruption are lacking for individuals treated in early HIV infection. Methods: Using CASCADE data, we compared the effect of treatment in early infection (within 12 months of seroconversion) with that seen in chronic infection on risk of virological failure, change and interruption. Failure was defined as two subsequent measures of HIV RNA> 1,000 copies/ml following suppression ( <500 copies/ml), or > 500 copies/ml 6 months following initiation. Treatment change and interruption were defined as modification or interruption lasting > 1 week. In multivariable competing risks proportional subdistribution hazards models, we adjusted for combination antiretroviral therapy (cART) class, sex, risk group, age, CD4(+) T-cell count, HIV RNA and calendar period at treatment initiation. Results: Of 1,627 individuals initiating cART early (median 1.8 months from seroconversion), 159, 395 and 692 failed, changed and interrupted therapy, respectively. For 2,710 individuals initiating cART in chronic infection (median 35.9 months from seroconversion), the corresponding values were 266, 569 and 597. Adjusted hazard ratios (HRs; 95% CIs) for treatment failure and change were similar between the two treatment groups (0.93 [0.72, 1.20] and 1.06 [0.91, 1.24], respectively). There was an increasing trend in rates of interruption over calendar time for those treated early, and a decreasing trend for those starting treatment in chronic infection. Consequently, compared with chronic infection, treatment interruption was similar for early starters in the early cART period, but the relative hazard increased over calendar time (1.54 [1.33, 1.79] in 2000). Conclusions: Individuals initiating treatment in early HIV infection are more likely to interrupt treatment than those initiating later. However, rates of failure and treatment change were similar between the two groups
AB - Background: Estimates of treatment failure, change and interruption are lacking for individuals treated in early HIV infection. Methods: Using CASCADE data, we compared the effect of treatment in early infection (within 12 months of seroconversion) with that seen in chronic infection on risk of virological failure, change and interruption. Failure was defined as two subsequent measures of HIV RNA> 1,000 copies/ml following suppression ( <500 copies/ml), or > 500 copies/ml 6 months following initiation. Treatment change and interruption were defined as modification or interruption lasting > 1 week. In multivariable competing risks proportional subdistribution hazards models, we adjusted for combination antiretroviral therapy (cART) class, sex, risk group, age, CD4(+) T-cell count, HIV RNA and calendar period at treatment initiation. Results: Of 1,627 individuals initiating cART early (median 1.8 months from seroconversion), 159, 395 and 692 failed, changed and interrupted therapy, respectively. For 2,710 individuals initiating cART in chronic infection (median 35.9 months from seroconversion), the corresponding values were 266, 569 and 597. Adjusted hazard ratios (HRs; 95% CIs) for treatment failure and change were similar between the two treatment groups (0.93 [0.72, 1.20] and 1.06 [0.91, 1.24], respectively). There was an increasing trend in rates of interruption over calendar time for those treated early, and a decreasing trend for those starting treatment in chronic infection. Consequently, compared with chronic infection, treatment interruption was similar for early starters in the early cART period, but the relative hazard increased over calendar time (1.54 [1.33, 1.79] in 2000). Conclusions: Individuals initiating treatment in early HIV infection are more likely to interrupt treatment than those initiating later. However, rates of failure and treatment change were similar between the two groups
U2 - https://doi.org/10.3851/IMP2312
DO - https://doi.org/10.3851/IMP2312
M3 - Article
C2 - 22910338
SN - 1359-6535
VL - 17
SP - 1039
EP - 1048
JO - Antiviral therapy
JF - Antiviral therapy
IS - 6
ER -