title: Efficacy of antiretroviral therapy switch in HIV-infected patients: a 10-year analysis of the EuResist Cohort.
abstract: BACKGROUND
  Highly active antiretroviral therapy (HAART) has been shown to be effective in many recent trials. However, there is limited data on time trends of HAART efficacy after treatment change.
  
  
  METHODS
  Data from different European cohorts were compiled within the EuResist Project. The efficacy of HAART defined by suppression of viral replication at 24 weeks after therapy switch was analyzed considering previous treatment modifications from 1999 to 2008.
  
  
  RESULTS
  Altogether, 12,323 treatment change episodes in 7,342 patients were included in the analysis. In 1999, HAART after treatment switch was effective in 38.0% of the patients who had previously undergone 1-5 therapies. This figure rose to 85.0% in 2008. In patients with more than 5 previous therapies, efficacy rose from 23.9 to 76.2% in the same time period. In patients with detectable viral load at therapy switch, the efficacy rose from 23.3 to 66.7% with 1-5 previous treatments and from 14.4 to 55.6% with more than 5 previous treatments.
  
  
  CONCLUSIONS
  The results of this large cohort show that the outcome of HAART switch has improved considerably over the last years. This result was particularly observed in the context after viral rebound. Thus, changing HAART is no longer associated with a high risk of treatment failure.
authors.affiliation: Clinic for General Medicine, Gastroenterology and Infectious Diseases, Augustinerinnen Hospital, Cologne, Germany. m.oette@koeln-kh-augustinerinnen.de
authors.forename: Mark
authors.initials: M
authors.lastname: Oette
authors.forename: Eugen
authors.initials: E
authors.lastname: Schülter
authors.forename: Michal
authors.initials: M
authors.lastname: Rosen-Zvi
authors.forename: Yardena
authors.initials: Y
authors.lastname: Peres
authors.forename: Maurizio
authors.initials: M
authors.lastname: Zazzi
authors.forename: Anders
authors.initials: A
authors.lastname: Sönnerborg
authors.forename: Daniel
authors.initials: D
authors.lastname: Struck
authors.forename: André
authors.initials: A
authors.lastname: Altmann
authors.forename: Rolf
authors.initials: R
authors.lastname: Kaiser
mesh_terms: D019380:Anti-HIV Agents / Q000008:administration & dosage*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents