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Virological failure to raltegravir in spain: Incidence, prevalence and clinical consequences

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dc.contributor Universitat de Vic - Universitat Central de Catalunya. Càtedra de la Sida i Malalties Relacionades
dc.contributor.author Santos, José R.
dc.contributor.author Blanco, José Luis
dc.contributor.author Masiá, Mar
dc.contributor.author Gutiérrez, Félix
dc.contributor.author Pérez-Elías, María Jesús
dc.contributor.author Iribarren, José Antonio
dc.contributor.author Force, Lluis
dc.contributor.author Antela, Antonio
dc.contributor.author Knobel, Hernando
dc.contributor.author Salavert, Miquel
dc.contributor.author López Bernaldo de Quirós, Juan Carlos
dc.contributor.author Pino, Maria
dc.contributor.author Paredes, Roger
dc.contributor.author Clotet, Bonaventura
dc.date.accessioned 2016-01-19T10:39:06Z
dc.date.available 2016-01-19T10:39:06Z
dc.date.created 2015
dc.date.issued 2015
dc.identifier.citation Santos J.R., Blanco J.L., Masiá M., Gutiérrez F., Pérez-Elías M.J., Iribarren J.A., et al. (2015). Virological failure to raltegravir in spain: Incidence, prevalence and clinical consequences. Journal of Antimicrobial Chemotherapy, 70(11), 3087-3095. ca_ES
dc.identifier.issn 1460-2091
dc.identifier.uri http://hdl.handle.net/10854/4405
dc.description.abstract Objectives: The objective of this study was to evaluate the incidence, prevalence and clinical consequences of virological failure (VF) to raltegravir-based regimens in Spain. Methods: A multicentre, retrospective, observational study was performed in 10 tertiary hospitals (January 2006 to June 2013). The study included HIV-1-infected patients with loss of virological suppression (LVS; two consecutive HIV-1 RNA ≥50 copies/mL) while receiving raltegravir. VF and low-level viraemia (LLV) were defined as two consecutive HIV-1 RNA ≥200 copies/mL and 50 to ,200 copies/mL, respectively. Integrase strand-transfer inhibitor resistance was investigated at LVS. During the 48 weeks following LVS, recorded data included clinical characteristics, treatment discontinuations, AIDS-associated events and deaths. Effectiveness of therapy following LVS was evaluated by ITT and PP. Multivariate regression was used to assess predictors of efficacy. Results: Of the 15009 HIV-infected patients in participating centres, 2782 (18.5%) had received raltegravirbased regimens. Of those, 192 (6.9%), 125 (4.5%) and 67 (2.4%) experienced LVS, VF and LLV, respectively. The incidence of VF was 1.8 (95% CI, 1.5–2.1) per 100 patients/year. The prevalence of VF was 4.5% (95% CI, 3.8%–5.3%). Integrase-associated mutations were found in 78.8% of patients with integrase genotyping results available. High-level resistance to dolutegravir was not observed. Salvage therapy failed in 34.1% of patients; progression to AIDS/death occurred in 8.3% during the first year following LVS. The latter was associated with intravenous drug use, time on raltegravir and lower CD4+ count nadir in patients who started raltegravirbased treatments as salvage regimens. Conclusions: VF with raltegravir is infrequent, but often associated with major clinical complications in treatment-experienced patients. ca_ES
dc.format application/pdf
dc.format.extent 9 p. ca_ES
dc.language.iso eng ca_ES
dc.publisher Oxford University Press ca_ES
dc.rights Tots els drets reservats ca_ES
dc.rights (c) Oxford University Press
dc.subject.other Sida -- Tractament ca_ES
dc.title Virological failure to raltegravir in spain: Incidence, prevalence and clinical consequences ca_ES
dc.type info:eu-repo/semantics/article ca_ES
dc.identifier.doi https://doi.org/10.1093/jac/dkv205
dc.rights.accesRights info:eu-repo/semantics/closedAccess ca_ES
dc.type.version info:eu-repo/publishedVersion ca_ES
dc.indexacio Indexat a SCOPUS ca_ES
dc.indexacio Indexat a WOS

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