title: Improved virological and immunological efficacy of resistance-guided switch in antiretroviral therapy: a Frankfurt HIV cohort analysis.
abstract: To evaluate the treatment outcome of antiretroviral therapy, depending on the use and utility of a concept of resistance-guided switch, patients from the Frankfurt HIV cohort have been followed for 24 weeks. If available, prior resistance data have been evaluated and patients were grouped into their expected viral response. The data of 354 patients were thus analysed, taking into account the genotypic sensitivity score of the administered medication (> or ≤2). When looking at the proportion of patients who achieved a viral load of <50/ml, the response rates differed significantly better for patients with a favourable resistance scoring as compared to an unfavourable one (71.9 % as compared to 56.0 %, p = 0.008). Interestingly, patients with a favourable resistance score also showed a better immunological response, as measured by median CD4 cell count of 391/µl [interquartal range (IQR) 250-530/µl] against 287/µl (IQR 174-449/µl) and a larger total increase of 141/µl against 38/µl. A significant virological and immunological benefit could be demonstrated for patients of a cohort with resistance-guided antiretroviral therapy adjustments.
authors.affiliation: Infectious Diseases Unit at Medical Department No. 2, HIVCENTER, Hospital of the Johann Wolfgang Goethe-University, Theodor Stern Kai 7, 60590, Frankfurt, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Wolf
authors.forename: B
authors.initials: B
authors.lastname: Fuß
authors.forename: P
authors.initials: P
authors.lastname: Khaykin
authors.forename: A
authors.initials: A
authors.lastname: Berger
authors.forename: G
authors.initials: G
authors.lastname: Knecht
authors.forename: P
authors.initials: P
authors.lastname: Gute
authors.forename: H R
authors.initials: HR
authors.lastname: Brodt
authors.forename: S
authors.initials: S
authors.lastname: Goepel
authors.forename: M
authors.initials: M
authors.lastname: Bickel
authors.forename: M
authors.initials: M
authors.lastname: Stuermer
authors.forename: C
authors.initials: C
authors.lastname: Stephan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D024882:Drug Resistance, Viral; D005260:Female; D006678:HIV / Q000187:drug effects*; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D016896:Treatment Outcome; D019562:Viral Load; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents