title: Effectiveness of etravirine-based therapy for treatment-experienced HIV-infected patients.
abstract: BACKGROUND
  Treatment options are limited for HIV-1-infected individuals who have received extensive previous antiretroviral therapy. ETV has shown significant clinical benefits in treatment-experienced HIV-1+ patients with antiretroviral resistance. The aim of this study was to evaluate the effectiveness of ETV plus optimized background regimen in real-life conditions in a cohort of highly HIV-1 antiretroviral-experienced patients.
  
  
  METHODS
  Retrospective cohort of treatment-experienced HIV-1-infected adults with virological failure who started therapy with an ETV-containing regimen. The effectiveness was evaluated using HIV-1 RNA viral load and changes in CD4+ cell count after 48 weeks of treatment.
  
  
  RESULTS
  Forty-two patients ≥ 16 years of age were included; 74% were men, and the median age was 45 years (IQR 41-53). All participants had prior non-nucleoside reverse transcriptase inhibitor use (55% nevirapine, 83%, efavirenz, and 28% both). Baseline median HIV-1 RNA viral load was 15,598 copies/mL (IQR 2651-84,175) and CD4+ cell count was 276 cells/mL (IQR 155-436). After 48 weeks of treatment, 90.5% (95% CI 78-96) of patients had HIV-1 RNA viral load < 200 copies/mL and 76% (95% CI 61-86) had < 50 copies/mL. CD4+ cell counts increased from baseline to 48 weeks of treatment to a median of 407 cells/mL (IQR 242-579); p < 0.001. Virological outcome was associated with virological failure at baseline HIV-1 RNA viral load ≥ 100,000 copies/mL (OR 7.6; 95% CI 1.2-44.80; p = 0.025).
  
  
  CONCLUSIONS
  Our study provides clinically important evidence of the effectiveness and safety of ETV in highly antiretroviral-experienced HIV-1-infected patients.
authors.affiliation: National Medical Center "Siglo XXI", IMSS, Distrito Federal, Distrito Federal, Mexico. gloriahuerta@gmail.com.
authors.forename: Gloria
authors.initials: G
authors.lastname: Huerta García
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Mata-Marín
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Domínguez-Hermosillo
authors.forename: Marcelino
authors.initials: M
authors.lastname: Chavez-García
authors.forename: Marco Issac
authors.initials: MI
authors.lastname: Banda-Lara
authors.forename: Nohemi
authors.initials: N
authors.lastname: Nuñez-Rodríguez
authors.forename: Javier Enrique
authors.initials: JE
authors.lastname: Cruz-Herrera
authors.forename: Jorge Luis
authors.initials: JL
authors.lastname: Sandoval-Ramírez
authors.forename: Alfredo
authors.initials: A
authors.lastname: Villagómez-Ruiz
authors.forename: Bulmaro
authors.initials: B
authors.lastname: Manjarrez-Tellez
authors.forename: Jesús Enrique
authors.initials: JE
authors.lastname: Gaytan-Martínez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects / Q000379:methods*; D018791:CD4 Lymphocyte Count; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009570:Nitriles; D011724:Pyridazines / Q000009:adverse effects / Q000627:therapeutic use*; D011743:Pyrimidines; D012367:RNA, Viral / Q000097:blood; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D019562:Viral Load; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D009570:Nitriles; D011724:Pyridazines; D011743:Pyrimidines; D012367:RNA, Viral; C451734:etravirine