R. Scott Braithwaite|Michael J. Kozal|Chung Chou H. Chang|Mark S. Roberts|Shawn L. Fultz|Matthew Bidwell Goetz|Cynthia Gibert|Maria C. Rodriguez?Barradas|L Molé|Amy C. Justice
Adherence, virological and immunological outcomes for HIV-infected veterans starting combination antiretroviral therapies
VA Connecticut Healthcare System|Yale University|Decision Sciences (United States)|University of Pittsburgh|Decision Sciences (United States)|University of Pittsburgh|University of California, Los Angeles|Washington University Medical Center|George Washington University|Michael E. DeBakey VA Medical Center|Baylor College of Medicine|VA Palo Alto Health Care System
objectives aimed determine adherence virological immunological outcomes one year starting first combination antiretroviral therapy art regimen design observational synthesis administrative laboratory pharmacy data antiretroviral regimens divided efavirenz nevirapine boosted protease inhibitor pi single pi categories propensity scores used control confounding treatment assignment adherence estimated pharmacy refill records setting veterans affairs healthcare system sites participants hivinfected individuals starting combination art low likelihood previous antiretroviral exposure interventions none outcomes proportion antiretroviral prescriptions filled prescribed change log hivrna proportion log hivrna viral suppression change cd4 cell count results total 6394 individuals unlikely previous antiretroviral exposure started combination art 1996 2004 eligible analysis adherence overall low 63 prescriptions filled prescribed adherence efavirenz 67 nevirapine 65 regimens significantly greater adherence boosted pi 59 single pi 61 regimens p 0001 efavirenz regimens likely suppress hivrna one year 74 compared nevirapine 62 boosted pi 63 single pi 53 regimens p 0001 superiority maintained analyses adjusted baseline clinical characteristics propensity treatment assignment efavirenz also yielded favorable immunological outcomes conclusion hivinfected individuals initiating first combination art using efavirenzbased regimen improved virological immunological outcomes greater adherence levels