Background Given the high budgetary impact of antiretroviral therapy (ART) and the lack of adherence to sometimes complex HIV treatment, it is interesting to analyse the reasons for changes between different ARTs.
Purpose To analyse the causes of change of ART in 439 patients over 16 months (January 2012–April 2013) in a general hospital.
Materials and methods Retrospective observational study included all HIV patients in the Farmatools Applicative Outpatient module version 2.4.
We defined 4 reasons for change in treatment and the following variables:
– Treatment failure: CD4, viral load (CV).
– Simplification of treatment: number of pills before/after the change.
– Adverse effects (AEs)
Results Of the 439 patients included, 39 patients had treatment changes, with 161 modifications.
Reasons for change:
11/161 for treatment failure. The median CV and CD4 were 13,997 copies/ml and 280 cells/mcL, respectively.
98/161, for simplicity. The commercial presentation was the most common reason for change (60/98). Of the 98 patients, 64 reduced 1 tablet in treatment, 32 reduced 2 tablets and 2 patients reduced 3 tablets. The mean reduction was 1.35. (SD = 0.53)
42/161 changes because of AEs: renal toxicity (14/44 patients), lipid disorders (8/44 patients), central nervous system disorders (6/44 patients), lipoatrophy (6/44 patients), osteopenia (3/44 patients) and others (5/44 patients).
10/161, changes for other reasons. 3/161 by treatment update. 5/161 for suspected interaction with other concomitant treatments (3 interactions with triple protease inhibitor treatment for hepatitis C, 1 interaction with omeprazole and another with methadone). 1/161, for dose adjustment in renal failure, 1/161 for unknown reasons.
Conclusions The main cause of treatment change was simplification, because new commercial presentations reduced the number of pills/doses or shots/day.
The second and third reasons were adverse effects and treatment failure, unlike those reflected in the literature.
No conflict of interest.
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