Suely Tuboi|Lee H. Harrison|Eduardo Sprinz|Ricardo K. Albernaz|Mauro Schechter
Predictors of Virologic Failure in HIV-1-Infected Patients Starting Highly Active Antiretroviral Therapy in Porto Alegre, Brazil
University of Pittsburgh
objective assess predictors virologic response 6 months initiation highly active antiretroviral therapy haart cohort hivinfected patients brazil methods treatmentnaive patients started haart 1996 2004 information viral load 39 months included information collected demographic characteristics antiretroviral regimen adherence aids diagnosis baseline cd4 cell count viral load virologic failure vf defined viral load 400 copiesml 6 months death completion 6 months therapy results among 454 patients met inclusion criteria vf occurred 127 280 univariate analysis vf associated younger age median 34 vs 37 years p 0003 aids diagnosis relative risk rr 118 p 0009 higher baseline viral load 534 vs 500 p 00002 lower baseline cd4 cell count 86 vs 182 p 0006 nonadherence rr 139 p 00001 regimen containing 1 single protease inhibitor compared ritonavirboosted regimens odds ratio 85 p 00001 year therapy initiated 1999 p 00001 minimize systematic effect therapy indication analyzed subset 158 patients cd4 count 200 cellsl started therapy 1999 adjusting age education adherence regimen baseline viral load nonadherence 878 p 002 fewer years education 605 p 005 remained associated vf conclusions significant improvement found virologic suppression time consistent introduction nonnucleoside reverse transcriptase inhibitors ritonavirboosted regimens clinical practice currently available therapies compliance education shown predictors virologic response particularly immunocompromised patients