title: Effectiveness and risk factors for virological outcome of darunavir-based therapy for treatment-experienced HIV-infected patients.
abstract: OBJECTIVE
  We evaluated the effectiveness of darunavir (DRV) treatment plus an optimized background regimen in 120 HIV-1 treatment-experienced patients.
  
  
  METHODS
  Retrospective cohort, multicenter study.
  
  
  METHODS
  Adults >16 years with virological treatment failure starting therapy with a DRV-containing regimen were included. Effectiveness was evaluated as the percentage of patients with an undetectable HIV-1 RNA viral load (<50 and <200 copies/mL) after 48 weeks, and changes in CD4+ cell counts. We evaluated the risk factors associated with treatment failure.
  
  
  RESULTS
  Of the cohort, 83 % were men with a median age of 45 years (interquartile range, IQR 40-51). They had experienced treatment for a median of 13 years (IQR 9-17) with a median of six previous regimens (IQR 4-7), all using protease inhibitors. After treatment, 82 % (95 % confidence interval, CI 74-88 %) of patients had an HIV-1 RNA viral load <200 copies/mL and 69 % (95 % CI 60-76 %) had <50 copies/mL. The CD4+ cell count increased by 378 cells/μL (IQR 252-559; P < 0.001 vs. baseline). Risk factors associated with poor outcome were age >40 years [odds ratio, OR 0.15 (95 % CI 0.10-0.78); P = 0.015], use of raltegravir in the regimen [OR 0.37 (95 % CI 0.10-0.97); P = 0.046], and baseline CD4+ cell count <200 cells/μL [OR 2.79 (95 % CI 1.11-6.97); P = 0.028].
  
  
  CONCLUSIONS
  In this Mexican cohort Darunavir was metabolically safe, well tolerated and achieved high rates of virological suppression in highly treatment-experienced patients infected with HIV-1.
authors.affiliation: Infectious Diseases Department, National Medical Center "La Raza", IMSS, Mexico Distrito Federal, Mexico ; Seris y Jacarandas s/n, Colonia "La Raza", Del Azcapotzalco, CP 02990 Ciudad de México D.F., Mexico.
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Mata-Marín
authors.affiliation: Pediatric Infectious Diseases Department, National Medical Center "Siglo XXI", IMSS, Mexico Distrito Federal, Mexico.
authors.forename: Gloria
authors.initials: G
authors.lastname: Huerta-García
authors.affiliation: Infectious Diseases Department, National Medical Center "La Raza", IMSS, Mexico Distrito Federal, Mexico.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Domínguez-Hermosillo
authors.affiliation: Infectious Diseases Department, Third Level Hospital No. 25, IMSS, Monterrey, NL Mexico.
authors.forename: Marcelino
authors.initials: M
authors.lastname: Chavez-García
authors.affiliation: AIDS Clinic, General Hospital No 2, IMSS, San Luis Potosí, S.L.P. Mexico.
authors.forename: Marco Isaac
authors.initials: MI
authors.lastname: Banda-Lara
authors.affiliation: AIDS Clinic, General Hospital No-24, IMSS, Mexico Distrito Federal, Mexico.
authors.forename: Nohemí
authors.initials: N
authors.lastname: Nuñez-Rodríguez
authors.affiliation: AIDS Clinic, General Hospital No.72, IMSS, Mexico Distrito Federal, Mexico.
authors.forename: Javier Enrique
authors.initials: JE
authors.lastname: Cruz-Herrera
authors.affiliation: Infectious Diseases Department, National Medical Center "La Raza", IMSS, Mexico Distrito Federal, Mexico.
authors.forename: Jorge Luis
authors.initials: JL
authors.lastname: Sandoval-Ramírez
authors.affiliation: AIDS Clinic, General Hospital No.72, IMSS, Mexico Distrito Federal, Mexico.
authors.forename: Ivan
authors.initials: I
authors.lastname: Martínez-Abarca
authors.affiliation: AIDS Clinic, Regional Hospital No. 1, IMSS, Culiacán, Sinaloa Mexico.
authors.forename: Alfredo Francisco
authors.initials: AF
authors.lastname: Villagómez-Ruíz
authors.affiliation: Infectious Diseases Department, National Medical Center "La Raza", IMSS, Mexico Distrito Federal, Mexico.
authors.forename: Bulmaro
authors.initials: B
authors.lastname: Manjarrez-Tellez
authors.affiliation: Infectious Diseases Department, National Medical Center "La Raza", IMSS, Mexico Distrito Federal, Mexico.
authors.forename: Jesús
authors.initials: J
authors.lastname: Gaytán-Martínez
keywords: Darunavir; Drug resistance; HIV; HIV-1 RNA; Virological outcome