Evolution of antiretroviral prescription and response over a period of 8 years: an Italian multicentre observational prospective cohort study.
BACKGROUND
There is very less information on the use of antiretroviral (ARV) drugs and viro-immunological outcome over calendar years in Italy.


METHODS
We performed an analysis of a prospective observational cohort (MASTER) to assess antiretroviral drug use in first line HAART and explore whether initial treatment response changed over the years.


RESULTS
3,648 ARV-naive patients with available HIV-RNA and CD4+ T cell count at baseline who started their first HAART between 1997 and 2004 were studied. Mean age was 37.7 years; they were mostly males (72.3%) and Italians (81.4%). Prescription of non-nucleoside reverse transcriptase inhibitors and protease inhibitors boosted with ritonavir rose from 0.3% in 1997 to 58% in 2004 and from 0.3%in 1997 to 33.4% in 2004, respectively. Virological failures decreased over calendar years: from 42.9% in 1997 to 8.1%in 2004 after 6 months of HAART (p<0.001); from 42.1%(1997) to 10.7% (2004) after 12 months (p<0.001) and; from 39.5% (1997) to 8.2% (2004) after 18 months (p<0.001). The same trend, but less striking, was found for immunological failure rates.


CONCLUSIONS
In the general Italian population of HIV-positive patients, evolution of treatment prescription correlated with improved viro-immunological outcome.
Sighinolfi
L
L
A.O. Sant'Anna, Ferrara, Italy.
Torti
C
C
Zeni
C
C
Ghinelli
F
F
Suter
F
F
Maggiolo
F
F
Antinori
A
A
Antonucci
G
G
Castelnuovo
F
F
Ladisa
N
N
Migliorino
M
M
Novati
S
S
De Luca
A
A
Lo Caputo
S
S
Paraninfo
G
G
Tinelli
C
C
Carosi
G
G
D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D006801:Humans; D007558:Italy; D008137:Longitudinal Studies; D008297:Male; D012367:RNA, Viral / Q000097:blood; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D017211:Treatment Failure; D016896:Treatment Outcome
D019380:Anti-HIV Agents; D012367:RNA, Viral; D018894:Reverse Transcriptase Inhibitors