title: Factors determining changes in initial antiretroviral therapy.
abstract: OBJECTIVE
  To investigate factors determining changes in initial antiretroviral therapy (ART) in patients attended to in an AIDS tertiary care hospital in Ceará, Brazil.
  
  
  METHODS
  This descriptive and exploratory study used the analysis of request to initiate or change treatment forms in the year of 2008, and the changes in therapy were followed through the first year of treatment. Data were analyzed with SPSS and EpiInfo by using ANOVA and the exact test of the coefficient of contingency, with significance at p < 0.05.
  
  
  RESULTS
  From 301 patients initiating ART, 22.1% (n = 68) needed a change in the first year. These patients were mostly males, aged 20 to 39 years; with only one ART changed needed in 86.8% of the cases (n = 59). Reports of two or three changes in regimen were observed. Zidovudine was the drug most often changed, followed by lopinavir/ritonavir and efavirenz. A significant association was found between changes in initial regimens and the report of adverse reactions (p < 0.001).
  
  
  CONCLUSIONS
  The main factor determining changes in the initial ART was an adverse reaction report. Most patients had one change in the initial ART over the first year of treatment. ART monitoring contributed to a better control of the specific drug therapy.
authors.affiliation: Public Health School of Ceará (ESP-CE), Brazil. deniseglvl@yahoo.com.br
authors.forename: Denise Girão Limaverde
authors.initials: DG
authors.lastname: Lima
authors.forename: Érico Antonio Gomes de
authors.initials: ÉA
authors.lastname: Arruda
authors.forename: Antonio Jorge Alves de
authors.initials: AJ
authors.lastname: Lima
authors.forename: Bruna Esmeraldo
authors.initials: BE
authors.lastname: Oliveira
authors.forename: Marta Maria de França
authors.initials: MM
authors.lastname: Fonteles
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D001938:Brazil; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D017211:Treatment Failure
chemical_list: D019380:Anti-HIV Agents