title: Effectiveness and Risk Factors for Virological Outcome of Raltegravir-Based Therapy for Treatment-Experienced HIV-Infected Patients.
abstract: OBJECTIVE
  We evaluated the effectiveness of a raltegravir (RAL)-containing regimen plus an optimized background regimen in HIV-1 highly treatment-experienced patients.
  
  
  METHODS
  A retrospective cohort, multicentre study was conducted.
  
  
  METHODS
  Adult (>16 years old) HIV treatment-experience patients starting therapy with a RAL-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 107 patients in the cohort, 86% were men, the median age was 45 years [interquartile range (IQR) 40-52] and the median number of previous regimens was six (IQR 4-7). After 48 weeks of treatment, 73% (IQR 63-80%) of patients (n = 78) had a viral load of <50 copies/mL and 85% (IQR 77-90%) (n = 91) had <200 copies/mL. In a logistic regression model, risk factors associated with a virological outcome of HIV-1 RNA of <200 copies/mL were age >40 years [odds ratio (OR) 5.61; 95% confidence interval (CI) 1.61-18.84; P = 0.006] and use of tenofovir in the regimen (OR 0.16; 95% CI 0.03-0.80; P = 0.026).
  
  
  CONCLUSIONS
  In this Mexican cohort, RAL achieved high rates of virological suppression and an increase in CD4+ cell count in highly treatment-experienced patients infected with HIV-1. Age >40 years was associated with a good virological outcome, contrary to tenofovir use, which was associated with a poor virological outcome.
authors.affiliation: Infectious Diseases Department, Hospital de Infectología, National Medical Center "La Raza", IMSS, Mexico City, Mexico.
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Mata-Marín
authors.affiliation: Medicine School, Universidad Anáhuac, Campus norte, Av. Universidad Anáhuac 46, Lomas Anahuac, 52786, Naucalpan de Juárez, Mexico City, Mexico. aweisers@gmail.com.
authors.forename: Ariane Estrella Weiser
authors.initials: AE
authors.lastname: Smeke
authors.affiliation: Medicine School, Universidad Anáhuac, Campus norte, Av. Universidad Anáhuac 46, Lomas Anahuac, 52786, Naucalpan de Juárez, Mexico City, Mexico.
authors.forename: Mariana Rotzinger
authors.initials: MR
authors.lastname: Rodriguez
authors.affiliation: Unidad Médica de Alta Especialidad No. 25, IMSS, Monterrey, Nuevo León, Mexico.
authors.forename: Marcelino
authors.initials: M
authors.lastname: Chávez-García
authors.affiliation: CLISIDA, HGR San Luis Potosí, IMSS, SLP, Mexico City, Mexico.
authors.forename: Marco Isaac
authors.initials: MI
authors.lastname: Banda-Lara
authors.affiliation: CLISIDA, HGR-110, IMSS, Guadalajara, Jalisco, Mexico.
authors.forename: Alma Minerva Pérez
authors.initials: AM
authors.lastname: Rios
authors.affiliation: CLISIDA, HGZ-24, IMSS, Mexico City, Mexico.
authors.forename: Nohemí
authors.initials: N
authors.lastname: Nuñez-Rodríguez
authors.affiliation: Infectious Diseases Department, Hospital de Infectología, National Medical Center "La Raza", IMSS, Mexico City, Mexico.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Domínguez-Hermosillo
authors.affiliation: Infectious Diseases Department, Hospital de Infectología, National Medical Center "La Raza", IMSS, Mexico City, Mexico.
authors.forename: Alberto Chaparro
authors.initials: AC
authors.lastname: Sánchez
authors.affiliation: CLISIDA, HGZ-29, IMSS, Mexico City, Mexico.
authors.forename: Irene
authors.initials: I
authors.lastname: Juarez-Kasusky
authors.affiliation: HGZ-72, Gustavo Baz, Tlalnepantla, Mexico City, Mexico.
authors.forename: Javier Enrique Cruz
authors.initials: JE
authors.lastname: Herrera
authors.affiliation: Infectious Diseases Department, Hospital de Infectología, National Medical Center "La Raza", IMSS, Mexico City, Mexico.
authors.forename: Jorge Luis Sandoval
authors.initials: JL
authors.lastname: Ramírez
authors.affiliation: Infectious Diseases Department, Hospital de Infectología, National Medical Center "La Raza", IMSS, Mexico City, Mexico.
authors.forename: Jesús
authors.initials: J
authors.lastname: Gaytán-Martínez
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1 / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D000068898:Raltegravir Potassium / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D019380:Anti-HIV Agents; D000068898:Raltegravir Potassium