title: Adherence and plasma drug concentrations are predictors of confirmed virologic response after 24-week salvage highly active antiretroviral therapy.
abstract: Data from 197 patients for whom highly active antiretroviral therapy (HAART) failed, who started a new regimen chosen under the guide of resistance testing results interpreted by experts, were retrospectively studied, provided that at least 2 determinations of adherence and plasma drug concentrations were performed during the follow-up. Univariate and multivariable logistic regression analyses were conducted, using confirmed virologic response at week 24 as outcome measure (i.e., achievement of undetectable HIV plasma viral load at any time point before week 24 and its maintenance up to week 24). Suboptimal drug concentrations (odds ratio [OR]: 0.3; 95% confidence interval [CI] 0.2-0.7; p = 0.006) and suboptimal adherence (OR: 0.4; 95% CI 0.2-0.8; p = 0.014) were both negative independent predictors of sustained virologic response, while the use of boosted protease inhibitor-containing regimens resulted to be protective (OR: 2.4; 95% CI 1.1-5.3; p = 0.032).
authors.affiliation: Institute for Infectious and Tropical Diseases, University of Brescia, Brescia, Italy.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Quiros-Roldan
authors.forename: Carlo
authors.initials: C
authors.lastname: Torti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lapadula
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Ladisa
authors.forename: Valeria
authors.initials: V
authors.lastname: Micheli
authors.forename: Andrea
authors.initials: A
authors.lastname: Patroni
authors.forename: Maria
authors.initials: M
authors.lastname: Cusato
authors.forename: Piera
authors.initials: P
authors.lastname: Pierotti
authors.forename: Valeria
authors.initials: V
authors.lastname: Tirelli
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Uccelli
authors.forename: Simona
authors.initials: S
authors.lastname: Di Giambenedetto
authors.forename: Filippo
authors.initials: F
authors.lastname: Castelnuovo
authors.forename: Franco
authors.initials: F
authors.lastname: Gargiulo
authors.forename: Nino
authors.initials: N
authors.lastname: Manca
authors.forename: Giampiero
authors.initials: G
authors.lastname: Carosi
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000097:blood* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010349:Patient Compliance; D016879:Salvage Therapy; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents