title: Antiretroviral therapy initiation in France: adherence to national guidelines and outcome.
abstract: OBJECTIVE
  Retrospective study of all patients who started antiretroviral therapy (ART) in 2007 in a single center in Paris, with baseline characteristics and 1-year outcome, to assess adherence to national guidelines.
  
  
  RESULTS
  We analyzed 118 patients. Time of ART initiation was in agreement with the guidelines for only 64 (54.2%) patients. Fifty patients (42%) started ART with AIDS or a CD4 count <200 cells/mm(3). In all, 62 (52%) and 47 patients (40%) received a combination of 2 nucleoside analogues with efavirenz (EFV) and 1 ritonavir-boosted protease inhibitor (PI/r), respectively. Treatment regimens were in accordance with the guidelines for 114 patients (97%). At 1 year, 16 patients (13.5%) were lost to follow-up, only 5 (4.9%) experienced HIV disease progression or death, but 19 (18.6%) required hospitalization. Antiretroviral therapy was changed in 21 patients (21%). Ten patients (8.4%) experienced virologic failure.
  
  
  CONCLUSIONS
  Antiretroviral therapy was in agreement with guidelines for the choice of combination but was often initiated too late.
authors: 1Department of Infectious Diseases, Saint Louis Hospital, AH-HP, and University of Paris Diderot, Paris, France.
authors: Vatthanaphone
authors: V
authors: Latthaphasavang
authors: Marie-Anne
authors: MA
authors: Bouldouyre
authors: Anne
authors: A
authors: Rachline
authors: Diane
authors: D
authors: Ponscarme
authors: Willy
authors: W
authors: Rozenbaum
authors: Jean-Yves
authors: JY
authors: Mary
authors: Constance
authors: C
authors: Delaugerre
authors: Jean-Michel
authors: JM
authors: Molina
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D000328:Adult; D000480:Alkynes; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D048588:Benzoxazines / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D003521:Cyclopropanes; D004359:Drug Therapy, Combination; D005260:Female; D005602:France; D019983:Guideline Adherence / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D019438:Ritonavir / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D003521:Cyclopropanes; D018894:Reverse Transcriptase Inhibitors; C098320:efavirenz; D019438:Ritonavir