Antiretroviral regimen change among people infected with HIV:evidence from a crosssectional study in China

Background:The rate of death among people living with HIV/AIDS has decreased significantly as a result of treatment with highly active antiretroviral therapy(HAART).However,the issues of drug induced toxicities and complexity of current HAART regimens has remained of great concern.The aim of this study was to determine factors in uencing antiretroviral regimen changes among people living with HIV/AIDS in China.Methods:This retrospective study collected data through face-to-face interviews with people living with HIV/AIDS who were receiving HAART,and gathered relevant information from infectious disease hospitals.The following information were collected:social-demographic characteristics,antiretroviral therapies,CD4 cell counts,virus loads,reasons for changing medication and other related data.Mean and percentages were used to describe the frequency of regimen change among patients,and binary logistic regression was employed to test the factors in uencing regimen change.Results:1,123 people who had experienced regimen change were included in the analysis.On average,patients remained on HAART for 10.2 months before changing regimen,and the average CD4 cell count and viral load(VL)were 383.1 cells/ l and 28,132.4 copies/mL respectively when changing regimen.The reasons for modi cation were determined as treatment failure(52.5%),adverse reactions(32.3%),and other reasons including pregnancy(15.2%).There are significant differences in regimen change among people with different genders(P<0.001),modes of transmission(P<0.001),duration of HAART(P<0.001)and initial CD4 cell counts(P=0.0024).Males,drug users,people taking long-term medication,and those with lower initial CD4 counts when starting HAART tend to change regimen.Conclusion:Treatment failure was the main reason for the change of HAART regimen.Males,drug users,people on longterm medication and those with lower initial CD4 cell counts when starting HAART were most likely to change regimen.

Changes in clinical indicators among human immunodeficiency virus patients who failed in antiretroviral therapy during 2004–2016 in Yunnan, China: an observational cohort study

Background:This study aimed to investigate the changes in the clinical indicators and influencing factors of treatment duration among human immunodeficiency virus(HIV)patients in whom antiretroviral therapy(ART)was unsuccessful.Methods:In this retrospective study,a total of 9,418 HIV patients who failed in ART during 2004–2016 were included and divided into two treatment groups—Group 1(treatment time≤3 years,n1=5,218)and Group 2(treatment time>3 years,n2=4,200).Patient follow-up data,including age,cluster of differentiation 4(CD4)count,and viral load,glucose,creatinine,and triglyceride levels,were extracted from electronic health record databases.Covariance analysis for repeated measures was used to analyze the biochemical indicators,and multiple logistic regression modeling was used to compare relevant data extracted from the Group 1 and Group 2 HIV patient cohorts with different treatment time.Results:The median initial CD4 count was 175.0 cells/μl(interquartile range,77.0–282.0),while the initial CD4 counts for Group 1 were lower than those for Group 2(P<0.05).A significant interaction between group and time effects was observed(P<0.05)in total cholesterol(TC).Changes in hemoglobin level among HIV patients were also significantly associated with treatment time(P=0.001).The initial CD4 count(odds ratio[OR]=0.756),female sex(OR=0.713),Zerit(d4T)(OR=1.443),TC(OR=1.285),and aspartate aminotransferase level(OR=1.002)were significantly associated with the survival time of dead patients with HIV(P<0.05).Additionally,the initial CD4 count(OR=1.456),age(OR=1.022),time interval(OR=0.903),patient’s living status(OR=0.597),d4T(OR=2.256),and triglyceride(OR=0.930)and hemoglobin levels(OR=0.997)were significantly associated with the treatment time of HIV patients with drug withdrawal(P<0.05).Conclusion:The initial biochemical parameters can affect the survival and treatment time of HIV patients.With a comprehensive understanding of the physiological and biochemical indicators of patients,we can reduce the probability of drug withdrawal and prolong the survival time of HIV patients.

Temporal Trends of Clinical Characteristics and Treatments in People Living with HIV at the Initiation of Antiretroviral Therapy — Beijing Municipality, China, 2010–2020

Summary What is already known about this topic?Antiretroviral therapy(ART)eligibility criteria and treatment regimens were updated in national guidelines.However,whether treatment was timely and followed guidelines was under-assessed.