Cocohoba Jennifer, Wang Qiong J, Cox Christopher, Gange Stephen J, Cohen Mardge, Glesby Marshall, DeHovitz Jack A, Greenblatt Ruth M
Department of Clinical Pharmacy, University of California San Francisco School of Pharmacy, San Francisco, CA 94143, USA.
J Acquir Immune Defic Syndr. 2008 Mar 1;47(3):377-83. doi: 10.1097/QAI.0b013e318160d552.
HIV treatment guidelines define optimal initial antiretroviral therapy (ART).
To characterize initial ART used by a cohort of HIV-infected women according to US HIV treatment guidelines and determine whether regimen characteristics predict short-term outcomes.
Initial ART self-reported by Women's Interagency HIV Study (WIHS) participants. Regimens were classified as guideline consistent (GC), guideline not recommended (GNR), or unlisted. Univariate and multivariate logistic regression was used to analyze factors associated with guideline category.
Two hundred seventeen WIHS participants initiated ART during the study period. Fifty-three percent reported use ofGC ART, 17% reported GNR ART, and 30% reported ART unlisted in guidelines. Study site, higher pretreatment CD4 cell count, lower HIV RNA level, and initiation before 2001 were associated with use of GNR regimens. GC ART users had a higher rise in CD4 cell counts and more frequent undetectable HIV-1 RNA levels 2 years after initiation compared with those GNR (P = 0.0003) or unlisted initial ART.
A higher than expected proportion of WIHS participants reported using initial ART not recommended by HIV treatment guidelines, although this decreased over time. Use of such regimens was associated with a higher incidence of switching and poorer short-term immunologic and virologic outcomes.
HIV治疗指南定义了最佳初始抗逆转录病毒疗法（ART）。
根据美国HIV治疗指南描述一组HIV感染女性使用的初始ART情况，并确定治疗方案特征是否可预测短期结局。
女性机构间HIV研究（WIHS）参与者自我报告的初始ART。治疗方案分为符合指南（GC）、指南不推荐（GNR）或未列出。采用单因素和多因素逻辑回归分析与指南类别相关的因素。
217名WIHS参与者在研究期间开始接受ART。53%报告使用GC ART，17%报告使用GNR ART，30%报告使用指南中未列出的ART。研究地点、治疗前较高的CD4细胞计数、较低的HIV RNA水平以及2001年前开始治疗与使用GNR方案相关。与GNR（P = 0.0003）或未列出的初始ART使用者相比，GC ART使用者在开始治疗2年后CD4细胞计数升高更高，HIV-1 RNA水平检测不到的频率更高。
WIHS参与者报告使用HIV治疗指南不推荐的初始ART的比例高于预期，尽管随着时间推移这一比例有所下降。使用此类方案与换药发生率较高以及短期免疫和病毒学结局较差相关。
