title: [Choice of initial regimen for antiretroviral-naïve HIV patients: Analysis of motivation].
abstract: OBJECTIVE
  Several therapeutic combination antiretroviral therapy regimen are available for initial treatment in naïve HIV infected patients. The choice of a particular regimen remains often subjective. The aim of this study was to determine factors associated with the choice of molecules in initial ARV prescriptions.
  
  
  METHODS
  From 01/01 to 30/10/2014, every initial cART prescription was analyzed regarding patients and physicians characteristics. Then, prescriptions were evaluated by an independent committee of ART prescribers.
  
  
  RESULTS
  One hundred and thirty two consecutive initial prescriptions by 34 physicians of 11 medical centers were included: 71 M, migrants: 57 %, MSM: 21 %, CD4<200/mm3: 26 %, HIV RNA>100 000 cp/mL (33 %). cART regimen were: NRTI/PI (43 %), NRTI/NNRTI (29.5 %), NRTI/integrase inhibitor (23 %). 75 % of initial cART regimen were consistent with expert guidelines recommendations. The choice of initial cART was not influenced by the type of HIV contamination risk group, patient's geographic origin, CD4 levels. In contrast, working or not (P=0.007), pregnancy wish (P=0.07), pregnancy (P=0.001), HIV RNA levels (P=0.02) and HIV primary infection (P=0.049) influenced the initial choice. Neither physician's age, nor physician's experience influenced this choice. The prescription's non accordance to 2013 French guidelines was mainly related to integrase inhibitor utilisation (P= 0.0001).
  
  
  CONCLUSIONS
  Overall, cART initial choice is mostly consistent with guidelines. Primary HIV infection, procreation features and high viral load are the main factors influencing this choice. New regimen with better tolerability is prescribed even if it is not yet included in the guidelines.
authors.affiliation: CHU Ambroise-Paré, AP-HP, 9, avenue Charles-de-Gaulle, 92100 Boulogne, France. Electronic address: elisabeth.rouveix@aphp.fr.
authors.forename: E
authors.initials: E
authors.lastname: Rouveix
authors.affiliation: CHU Louis-Mourier, AP-HP, 178, rue des Renouillers, 92700 Colombes, France.
authors.forename: E
authors.initials: E
authors.lastname: Mortier
authors.affiliation: CHU Ambroise-Paré, AP-HP, 9, avenue Charles-de-Gaulle, 92100 Boulogne, France.
authors.forename: A
authors.initials: A
authors.lastname: Beauchet
authors.affiliation: CHU Ambroise-Paré, AP-HP, 9, avenue Charles-de-Gaulle, 92100 Boulogne, France.
authors.forename: C
authors.initials: C
authors.lastname: Dupont
authors.affiliation: Centre hospitalier Max-Fourestier, 403, avenue de la République, 92000 Nanterre, France; Centre hospitalier Victor-Dupouy, 69, rue du Lieutenant-Colonel-Prud'hom, 95107 Argenteuil, France.
authors.forename: J
authors.initials: J
authors.lastname: Gerbe
authors.affiliation: Centre hospitalier Max-Fourestier, 403, avenue de la République, 92000 Nanterre, France.
authors.forename: V
authors.initials: V
authors.lastname: Daneluzzi
authors.affiliation: CHI de St-Germain-en-Laye, 20, rue Armagis, 78100 St-Germain-en-Laye, France.
authors.forename: P
authors.initials: P
authors.lastname: Brazille
authors.affiliation: CHU Raymond-Poincaré, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France.
authors.forename: H
authors.initials: H
authors.lastname: Berthe
authors.affiliation: CMC Foch, 40, rue Worth, 92151 Suresnes, France.
authors.forename: D
authors.initials: D
authors.lastname: Zucman
authors.affiliation: Centre hospitalier Victor-Dupouy, 69, rue du Lieutenant-Colonel-Prud'hom, 95107 Argenteuil, France.
authors.forename: P
authors.initials: P
authors.lastname: Genet
authors.affiliation: CHU Louis-Mourier, AP-HP, 178, rue des Renouillers, 92700 Colombes, France.
authors.forename: A-M
authors.initials: AM
authors.lastname: Simonpoli
authors.affiliation: CHU Raymond-Poincaré, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France.
authors.forename: P
authors.initials: P
authors.lastname: de Truchis
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005602:France; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D055656:Prescriptions / Q000706:statistics & numerical data*
chemical_list: D019380:Anti-HIV Agents
keywords: Antiretroviral agents; Antirétroviraux; HIV infection; Initial prescriptions; Naïve infected patients; Patients naïfs; Primo-prescription; Recommandations; Recommendations; VIH