Background Since the introduction of HAART, HIV has become a chronic disease. Maintaining adherence and persistence to treatment are key elements in the pharmacotherapeutic follow-up. Persistence adds the dimension of time to the analysis and represents the time over which a patient continues to collect a prescription.
Purpose To determine the persistence with treatment-naive HIV+ patients in the PSITAR cohort.
Material and methods Prospective multicentre study. Inclusion criteria: treatment-naïve patients who started antiretroviral therapy in 2011 and 2012 and monitoring in pharmaceutical care consultations of the centres involved. Demographic characteristics, virological parameters and pharmacotherapy variables: regimen prescribed, adherence to treatment, time to discontinuation and its cause.
Patients were classified according to the treatment received: 2NRTI + NNRTI, 2 NRTI + PI/r or 2NRTI + INSTI.
HAART persistence was measured as the time (in weeks) from the start of treatment until discontinuation due to treatment modification or abandonment for more than 90 days.
The evolution of persistence was tracked through survival curves using the Kaplan-Meier method, even considering no persistence.
Results 227 patients were included, 82.4% men. The mean age was 40 ± 11. The most frequent HAART consisted of 2NRTI + NNRTI (65.6%). A percentage of 43.2% was persisting with the same initial treatment at the end of the observation period. The median time to discontinuation was 76.4 weeks (CI95%: 56.8–96.0) and the main cause of discontinuation was adverse effects (70.6%).
Median persistence was 88.8 (CI95%: 73.2–104) weeks for the treatment with 2NRTI + NNRTI, 42.4 (CI95%: 35.2–50.0) with 2 NRTI + PI/r and 29.6 (CI95%: 4.8–54.4) with 2NRTI + INSTI.
Statistically significant differences were found in time to discontinuation between treatment groups with a third drug NNRTI versus PI/r (p = 0.001), the higher time to discontinuation being in the NNRTI group.
Conclusion Patients starting antiretroviral therapy with 2NRTI + NNRTI had better persistence with a median time to discontinuation of nearly two years.
Value Health 2008;11(1):44–7
ReferencesNo conflict of interest.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.