Penna Braga Letícia, Pinto Mendicino Cássia Cristina, Reis Edna Afonso, Carmo Ricardo Andrade, Menezes de Pádua Cristiane
Department of Social Pharmacy, Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
Department of Statistics, Exact Sciences Institute, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
J Trop Med. 2017;2017:9612653. doi: 10.1155/2017/9612653. Epub 2017 Feb 27.
This study estimated the incidence of and time to first antiretroviral therapy (ART) modification. This longitudinal analysis comprised a sample of 236 patients from three HIV/AIDS referral centers in Belo Horizonte, Brazil-part of a major historical cohort. Inclusion criteria were as follows: having been treatment-naive patient ≥18 years old who initiated ART between 2001 and 2005 in these three referral centers. The main endpoint was time to first ART modification. Patients were followed up for five years, covering the period 2001-2010, during which time Pearson's chi-square test was performed to compare ART modification between groups. Kaplan-Meier inverse survival curves were employed to describe the probability of ART modification and Cox proportional hazard regression was used to estimate the adjusted hazard ratio (aHR) of ART modification. Among 247 patients from the major cohort, 236 were eligible. Median follow-up time was 37.2 months and the contribution in person-months was 7,615.4 months. A total of 108 (45.8%) patients had their ART regimen modified at least once (incidence rate: 1.42 per 100 person-months). Adverse drug reactions were the main reason for ART modification. Women (aHR = 1.62; = 0.022) and patients on protease inhibitor- (PI-) based regimens (aHR = 2.70; < 0.001) were at higher risk of ART modification.
本研究估算了首次抗逆转录病毒疗法（ART）调整的发生率及时间。这项纵向分析纳入了来自巴西贝洛奥里藏特三个艾滋病毒/艾滋病转诊中心的236名患者样本，这是一个大型历史队列的一部分。纳入标准如下：2001年至2005年期间在这三个转诊中心开始接受ART治疗的初治患者，年龄≥18岁。主要终点是首次ART调整的时间。对患者进行了为期五年的随访，涵盖2001年至2010年期间，在此期间进行了Pearson卡方检验以比较各组之间的ART调整情况。采用Kaplan-Meier逆生存曲线描述ART调整的概率，并使用Cox比例风险回归来估计ART调整的调整风险比（aHR）。在主要队列的247名患者中，236名符合条件。中位随访时间为37.2个月，人月贡献为7615.4个月。共有108名（45.8%）患者至少有一次ART方案调整（发生率：每100人月1.42次）。药物不良反应是ART调整的主要原因。女性（aHR = 1.62；P = 0.022）和接受基于蛋白酶抑制剂（PI）方案治疗的患者（aHR = 2.70；P < 0.001）ART调整风险更高。
