Efficacy of 1998 Vs 2006 First-Line Antiretroviral Regimens for HIV Infection: An Ordinary Clinics Retrospective Investigation
Giustino Parruti1*, Ennio Polilli1, Giuseppe Vittorio De Socio2, Federica Sozio1, Patrizia Marconi3, Viviana Soddu4, Margherita Dalessandro5, Benedetto Maurizio Celesia6, Giovanni Pellicanò7, Giordano Madeddu4, Jacopo Vecchiet5, Francesco Di Masi1, Elena Mazzotta1, Tamara Ursini1, Canio Martinelli8, Paola Vitiello9, Paolo Bonfanti9, Luciano Nigro6, Maria Stella Mura4, Andrea Antinori3, Elena Ricci9 and Lamberto Manzoli10
- *Corresponding Author:
- Dr. Giustino Parruti
Infectious Disease Unit
Pescara General Hospital
E-mail: [email protected]
Received Date: March 23, 2012; Accepted April 19, 2012; Published Date: April 21, 2012
Citation: Parruti G, Polilli E, De Socio GV, Sozio F, Marconi P, et al. (2012) Efficacy of 1998 Vs 2006 First-Line Antiretroviral Regimens for HIV Infection: An Ordinary Clinics Retrospective Investigation. J Antivir Antiretrovir 4: 032-037. doi: 10.4172/jaa.1000043
Copyright: © 2012 Parruti G, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Purpose: The evidence suggesting increased HAART efficacy over time comes from randomized trials or cohort studies. This retrospective multicenter survey aimed to assess the variation over time in the efficacy and tolerability of first-line HAART regimens in unselected patients treated in ordinary clinical settings.
Methods: Retrospective analysis of data of all patients starting first-line HAART regimens in 1998 and 2006 at adhering centers in the Italian CISAI group.
Results: For the 543 patients included, mean age was 39.1 ± 9.8y in 1998 and 41.0 ± 10.7y in 2006 (p=0.03), with a similar proportion of males. Baseline mean log10 HIV-RNA was 4.56 ± 0.97 copies/mL in 1998 vs 4.91 ± 0.96 copies/mL in 2006 (p<0.001); baseline mean CD4 T-cell counts were 343 ± 314/mm3 in 1998 vs 244 ± 174/mm3 in 2006 (p<0.001). The following outcomes were significantly improved at 48w in 2006: proportion with undetectable HIV-RNA (86.3% vs 58.0%; p<0.001); mean increase in CD4 T-cells count (252 ± 225 vs 173 ± 246; p<0.001); HAART modification (20.1% vs 29.2%; p=0.02); HAART interruption (7.3% vs 14.6%; p=0.01); proportion reporting optimal adherence (92.2% vs 82.7%, p=0.03). No differences were observed in the prevalence of grade 3-4 WHO toxicities (26.4% vs 26.6%; p=0.9). Multivariate logistic regression showed that being treated in 1998 remained an independent predictor of virological failure after several adjustments, including adherence.
Conclusions: Our data from patients not included in clinical trials or cohort studies provide an additional line of evidence that the effectiveness of HAART significantly improved in 2006. Treated patients, however, were significantly older and more frequently late HIV presenters in 2006 than in 1998.