title: The choice between a ritonavir-boosted protease inhibitor- and a non-nucleoside reverse transcriptase inhibitor-based regimen for initiation of antiretroviral treatment - results from an observational study in Germany.
abstract: BACKGROUND
  This study aims at identifying predictors of the treatment decision of German physicians with regard to a non-nucleoside reverse transcriptase inhibitor (NNRTI) or a ritonavir-boosted protease inhibitor (PI/r) -based initial treatment regimen.
  
  
  METHODS
  The study is based on a sub analysis of a nation-wide multi-centre, non-interventional, prospective cohort study. 133 patients were identified, who received antiretroviral first-line therapy. By means of a logistic regression, factors that determine the treatment strategy for treatment-naïve patients were analysed.
  
  
  RESULTS
  Compared to patients receiving a NNRTI-based initial regimen, patients treated with PI/r are slightly younger, less educated, in a later stage of HIV and have more concomitant diseases. Regression analysis revealed that being in a later stage of HIV (CDC-C) is significantly associated with a PI/r-based treatment decision.
  
  
  CONCLUSIONS
  Our analysis is the first study in Germany investigating sociodemographic and disease-specific parameters associated with a NNRTI- or a PI/r-based initial treatment decision. The results confirm that the treatment decision for a PI/r strategy is associated with disease severity.
authors.affiliation: Janssen KK, Health Economics, Tokyo, Japan ; Heinrich-Heine University of Düsseldorf, Düsseldorf Institute for Competition Economics (DICE), Düsseldorf, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Mahlich
authors.affiliation: Heinrich-Heine University of Düsseldorf, Düsseldorf Institute for Competition Economics (DICE), Düsseldorf, Germany.
authors.forename: Mona
authors.initials: M
authors.lastname: Groß
authors.affiliation: University of Hanover, Centre for Health Economics Research, Hanover, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Kuhlmann
authors.affiliation: Division of Infectious Diseases, Ludwig Maximilian University of Munich, Munich, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Bogner
authors.affiliation: Private Practice, Hanover, Germany.
authors.forename: Hans
authors.initials: H
authors.lastname: Heiken
authors.affiliation: Hannover Medical School (MHH), Centre for Internal Medicine, Hanover, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Stoll
keywords: AIDS; Antiretroviral treatment; HIV infection; NNRTI; PI; Treatment decision