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CP-173 Assessment of efficacy of multiple antiretroviral therapy
  1. A Martínez Valero,
  2. R Gutiérrez Vozmediano,
  3. R Antón Torres,
  4. F Rodríguez-Lucena,
  5. E García Iranzo,
  6. A Navarro Ruíz
  1. Hospital General Universitario de Elche, Servicio de Farmacia, Elche, Spain

Abstract

Background Patients with multiple antiretroviral therapy (MAT), defined as a combination of at least 3 drugs with different mechanisms of action, are on a difficult and costly treatment which may also affect treatment adherence.

Purpose To describe characteristics of HIV patients with multiple antiretroviral therapy and to evaluate the efficacy and adherence to the treatment.

Material and methods Retrospective observational study from June to December 2013. The inclusion criteria for our study were: MAT patients without changes in their treatment in the last 24 weeks. Data collected: demographics, current MAT, duration of treatment for HIV, adherence, resistance profile, viral load (VL) and CD4 count. Patients were classified as adherent (>90%) and non-adherent (<90%) by two independent methods: pharmacy dispensing records and SMAQ (simplified medicines adherence questionnaire) interview. Efficacy was evaluated by CD4 cells count and VL < 50 copies/mL, however we also considered CV < 200 copies/mL as a good indicator of treatment response.

Results A total of 49 patients were eligible in this study, 76% male, mean age 46.5 ± 9.9 years. The mean no. of MAT drugs was 4 (range 3–6) and the mean duration of treatment for HIV was 12 (range 1–17) years. Regarding resistance studies: 9 patients were resistant to some antiretroviral, it was not possible to perform resistance studies in 10 patients (20.4%) due to the low VL (<1,000 copies/mL), it was not requested in 28 patients (57.1%) and 2 patients did not show resistance. Seven, eight and two patients showed resistance to analogues, non-analogues and protease inhibitors, respectively. The mean adherence was 94% and 40 patients (81.6%) had a percentage adherence superior to 90%. As to the efficacy variables: 32 (65.3%) and 46 (93.8%) patients had VL < 50 copies/mL and <200 copies/mL, respectively and 40 patients (81.6%) had a CD4 cell count >250 copies/mL.

Conclusion Most patients had effective treatments. The complexity of the treatment did not have a negative impact on adherence. All patients with a resistance profile had their treatment optimised according to it.

References and/or Acknowledgements No conflict of interest.

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