title: Evolution of antiretroviral prescription and response over a period of 8 years: an Italian multicentre observational prospective cohort study.
abstract: 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.
authors.affiliation: A.O. Sant'Anna, Ferrara, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Sighinolfi
authors.forename: C
authors.initials: C
authors.lastname: Torti
authors.forename: C
authors.initials: C
authors.lastname: Zeni
authors.forename: F
authors.initials: F
authors.lastname: Ghinelli
authors.forename: F
authors.initials: F
authors.lastname: Suter
authors.forename: F
authors.initials: F
authors.lastname: Maggiolo
authors.forename: A
authors.initials: A
authors.lastname: Antinori
authors.forename: G
authors.initials: G
authors.lastname: Antonucci
authors.forename: F
authors.initials: F
authors.lastname: Castelnuovo
authors.forename: N
authors.initials: N
authors.lastname: Ladisa
authors.forename: M
authors.initials: M
authors.lastname: Migliorino
authors.forename: S
authors.initials: S
authors.lastname: Novati
authors.forename: A
authors.initials: A
authors.lastname: De Luca
authors.forename: S
authors.initials: S
authors.lastname: Lo Caputo
authors.forename: G
authors.initials: G
authors.lastname: Paraninfo
authors.forename: C
authors.initials: C
authors.lastname: Tinelli
authors.forename: G
authors.initials: G
authors.lastname: Carosi
mesh_terms: 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
chemical_list: D019380:Anti-HIV Agents; D012367:RNA, Viral; D018894:Reverse Transcriptase Inhibitors