Patient Characteristics and Treatment Outcome Associated with Protease Inhibitor (PI) use in the Asia-Pacific Region.
OBJECTIVES: Regimens containing protease inhibitors (PI) are less commonly used in developing countries due to high cost and less availability. We evaluated characteristics of patients initiating PI-based therapy according to previous antiretroviral (ARV) exposure; factors associated with initiating a PI-containing regimen using newer versus older PIs, and proportion of patients with detectable viral loads (VL) after initiating a PI-based regimen. METHODS: This analysis includes all patients who have initiated a PI-based regimen. ARV exposure was categorised: naïve (no previous ARV), 1st, 2nd, >/= 3rd switches; a switch was defined as starting or stopping any drug in a regimen. Newer PIs were defined as those approved by the US FDA after 1 January 2000. Detectable VL at 12 months was defined as VL >/= 400 copies/mL. Characteristics at PI initiation were evaluated. Logistic regression was used to determine factors associated with initiating a newer PI and detectable VL at 12 months after PI initiation. RESULTS: 1106 patients initiated PI-based therapy; of these, 618 (56%) were naïve patients. Overall, 22% (176) of patients had detectable VL at 12 months following the PI initiation. Being from a high income country (vs. mid/low income, OR = 1.80, p = 0.034) were more likely to be associated with detectable VL. CONCLUSION: The use of PIs in this cohort is dictated by accessibility and affordability issues particularly for the newer PIs. Short-term virological outcomes following PI-therapy in our cohort were good, and were associated with CD4 count at time of initiation.
Pujari
Sanjay
S
Institute of Infectious diseases, Pune India.
Srasuebkul
Preeyaporn
P
Sungkanuparph
Somnuek
S
Lim
Poh Lian
PL
Kumarasamy
Nagalingeswaran
N
Chuah
John
J
Kumar
Ritesh N
RN
Chen
Yi-Ming A
YM
Oka
Shinichi
S
Choi
Jun Yong
JY
Lee
Man-Po
MP
Phanuphak
Praphan
P
Kamarulzaman
Adeeba
A
Lee
Christopher
C
Fujie
Zhang
Z
Ditangco
Rosanna
R
Saphonn
Vonthanak
V
Sirisanthana
Thira
T
Merati
Tuti Parwati
TP
Smith
Jeff
J
Law
Matthew G
MG