Background The main objective of antiretroviral therapy (ART) is to maintain undetectable viral load (VL) and preserve immune function. But nowadays reduction in morbidity and improvements in patient quality of life appear to be as important therapy goals, encouraging clinicians to change ART although VL and immune function are controlled.
Purpose The aim of our study was to assess the reasons for ART switches in patients with effective previous treatment (undetectable VL) and to analyse if these switches had been done according to the GESIDA (Grupo de Estudio del SIDA, AIDS Study Group) 2015 guidelines.
Material and methods An observational retrospective study was carried out from June 2014 to January 2015. All patients with ART during this period were included, and patients who underwent treatment switching were analysed. Previous and actual treatments, pre-switch VL, and reasons for the switch were recorder in a database. Pregnant patients and those with detectable VL were excluded from the final analysis in relation to its adaptation to the GESIDA 2015 guideline recommendations.
Results 781 patients were included. 120 treatments were switched (15.4): 103 patients had undetectable VL, 13 patients had detectable VL and 4 patients were pregnant. The reasons for switching in patients with undetectable VL are shown in table 1.
Analysing our clinicians reasons for switching according to the GESIDA recommendations (excluding unknown reasons), we found that 32% of switches had no defined level of evidence; 17% had a level of evidence BII; 2% BI; 10% AIII; 20% AII; and 19% AI.
Conclusion The main reason for ART switching in patients with undetectable VL was side effects. Nearly one-third of all switches did not correspond to any level of evidence, according to the GESIDA 2015 guidelines. Among the switches that followed the recommendation, 71% had a level of evidence of A.
No conflict of interest.
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