title: Virologic and immunologic effectiveness at 48 weeks of darunavir-ritonavir-based regimens in treatment-experienced persons living with HIV-1 infection in clinical practice: a multicenter Brazilian cohort.
abstract: BACKGROUND
  Published data addressing the effectiveness of darunavir-ritonavir (DRV/r)-based therapy for multiexperienced patients in developing countries are scarce. This study evaluated the 48-week virologic and immunologic effectiveness of salvage therapy based on DRV/r for the treatment of multidrug-experienced HIV-1-infected adults in Brazil.
  
  
  METHODS
  A multicenter retrospective cohort study was carried out with multidrug-experienced adults who were on a failing antiretroviral therapy and started a DRV/r-based salvage therapy between 2008 and 2010. The primary effectiveness end point was the proportion of patients with virologic success (plasma HIV-1 RNA <50 copies/mL at week 48).
  
  
  RESULTS
  At 48 weeks, 73% of the patients had HIV-RNA <50 copies/mL and a mean increase of 108 CD4 cells/mm(3). Higher baseline viral load, lower baseline CD4 count, younger age, and 3 or more DRV/r-associated resistance mutations were significantly predictive of virologic failure. Concomitant use of raltegravir was strongly associated with virologic success.
  
  
  CONCLUSIONS
  The use of DRV/r-based regimens for salvage therapy is an effective strategy in the clinical care setting of a developing country.
authors.affiliation: Infectious Disease and Tropical Medicine Postgraduate Course, Minas Gerais Federal University, School of Medicine, Belo Horzonte, Brazil.
authors.forename: Fernando Martín
authors.initials: FM
authors.lastname: Biscione
authors.forename: Mateus Rodrigues
authors.initials: MR
authors.lastname: Westin
authors.forename: Karina Mota
authors.initials: KM
authors.lastname: Ribeiro
authors.forename: Denize Lotufo
authors.initials: DL
authors.lastname: Estevam
authors.forename: Sandra Wagner
authors.initials: SW
authors.lastname: Cardoso
authors.forename: Simone Barros
authors.initials: SB
authors.lastname: Tenore
authors.forename: Lauro Ferreira da Silva Pinto
authors.initials: LF
authors.lastname: Neto
authors.forename: Paulo Ricardo
authors.initials: PR
authors.lastname: Alencastro
authors.forename: Theodoro Armando
authors.initials: TA
authors.lastname: Suffert
authors.forename: Mônica Jacques
authors.initials: MJ
authors.lastname: de Moraes
authors.forename: Alexandre Naime
authors.initials: AN
authors.lastname: Barbosa
authors.forename: Karen Mirna Loro
authors.initials: KM
authors.lastname: Morejón
authors.forename: Érico Antônio Gomes
authors.initials: ÉA
authors.lastname: de Arruda
authors.forename: Jussara María
authors.initials: JM
authors.lastname: Silveira
authors.forename: José Luiz Andrade
authors.initials: JL
authors.lastname: Neto
authors.forename: Dirceu Bartolomeu
authors.initials: DB
authors.lastname: Greco
authors.forename: Unaí
authors.initials: U
authors.lastname: Tupinambás
mesh_terms: D000328:Adult; D001938:Brazil; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D000069454:Darunavir; D024882:Drug Resistance, Viral; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D017320:HIV Protease Inhibitors / Q000627:therapeutic use*; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D019438:Ritonavir / Q000627:therapeutic use*; D013449:Sulfonamides / Q000627:therapeutic use*; D019562:Viral Load
chemical_list: D017320:HIV Protease Inhibitors; D013449:Sulfonamides; D019438:Ritonavir; D000069454:Darunavir
keywords: HIV; antiretroviral; darunavir; resistance