title: Real-world persistence with antiretroviral therapy for HIV in the United Kingdom: A multicentre retrospective cohort study.
abstract: Persistence with an antiretroviral therapy (ART) regimen for HIV can be defined as the length of time a patient remains on therapy before stopping or switching. We aimed to describe ART persistence in treatment naïve patients starting therapy in the United Kingdom, and to describe differential persistence by treatment regimen.
  
  
  
  We performed a retrospective cohort study at eight UK centres of ART-naïve adults commencing ART between 2012 and 2015. Aggregate data were extracted from local treatment databases. Time to discontinuation was compared for different third agents and NRTI backbones using incidence rates.
  
  
  
  1949 patients contributed data to the analysis. Rate of third agent change was 28 per 100 person-years of follow up [95% CI 26-31] and NRTI backbone change of 15 per 100 person-years of follow up [95% CI 14-17]). Rilpivirine, as co-formulated rilpivirine/tenofovir/emtricitabine had a significantly lower discontinuation rate than all other third agents and, excluding single tablet regimens, co-formulated tenofovir/emtricitabine had a significantly lower discontinuation rate than co-formulated abacavir/lamivudine. The reasons for discontinuation were not well recorded.
  
  
  
  Treatment discontinuation is not an uncommon event. Rilpivirine had a significantly lower discontinuation rate than other third agents and tenofovir/emtricitabine a lower rate than co-formulated abacavir/lamivudine.
authors.affiliation: Royal Liverpool University Hospital, UK; Wellcome Trust Liverpool Glasgow Centre for Global Health Research, Liverpool, UK. Electronic address: jmlewis@liverpool.ac.uk.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Lewis
authors.affiliation: University College London, UK.
authors.forename: Colette
authors.initials: C
authors.lastname: Smith
authors.affiliation: North Manchester General Hospital, UK.
authors.forename: Adele
authors.initials: A
authors.lastname: Torkington
authors.affiliation: North Manchester General Hospital, UK.
authors.forename: Craig
authors.initials: C
authors.lastname: Davies
authors.affiliation: North Manchester General Hospital, UK.
authors.forename: Shazaad
authors.initials: S
authors.lastname: Ahmad
authors.affiliation: North Manchester General Hospital, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Tomkins
authors.affiliation: Manchester Centre for Sexual Health, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Shaw
authors.affiliation: Manchester Centre for Sexual Health, UK.
authors.forename: Margaret
authors.initials: M
authors.lastname: Kingston
authors.affiliation: St Georges Hospital, London, UK.
authors.forename: Ghadeer
authors.initials: G
authors.lastname: Muqbill
authors.affiliation: St Georges Hospital, London, UK.
authors.forename: Philip
authors.initials: P
authors.lastname: Hay
authors.affiliation: Brighton and Sussex University Hospital, UK.
authors.forename: Larissa
authors.initials: L
authors.lastname: Mulka
authors.affiliation: Brighton and Sussex University Hospital, UK.
authors.forename: Deborah
authors.initials: D
authors.lastname: Williams
authors.affiliation: Mortimer Market Centre, London, UK.
authors.forename: Laura
authors.initials: L
authors.lastname: Waters
authors.affiliation: Mortimer Market Centre, London, UK.
authors.forename: Nataliya
authors.initials: N
authors.lastname: Brima
authors.affiliation: Royal Free London, UK.
authors.forename: Neal
authors.initials: N
authors.lastname: Marshall
authors.affiliation: Royal Free London, UK.
authors.forename: Margaret
authors.initials: M
authors.lastname: Johnson
authors.affiliation: Royal Liverpool University Hospital, UK.
authors.forename: Mas
authors.initials: M
authors.lastname: Chaponda
authors.affiliation: Chelsea and Westminster Hospital, London, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Nelson
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D003841:Deoxycytidine / Q000627:therapeutic use; D015224:Dideoxynucleosides / Q000627:therapeutic use; D004338:Drug Combinations; D000068679:Emtricitabine / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology; D015497:HIV-1 / Q000187:drug effects; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D012189:Retrospective Studies; D000068696:Rilpivirine / Q000627:therapeutic use; D000068698:Tenofovir / Q000627:therapeutic use; D006113:United Kingdom / Q000453:epidemiology; D019562:Viral Load / Q000187:drug effects; D000099227:Abacavir
chemical_list: D019380:Anti-HIV Agents; D003841:Deoxycytidine; D015224:Dideoxynucleosides; D004338:Drug Combinations; D000068679:Emtricitabine; D019259:Lamivudine; D000068696:Rilpivirine; D000068698:Tenofovir; C492871:abacavir, lamivudine drug combination; D000099227:Abacavir
keywords: ART; Adherence; Antiretroviral therapy; HIV; Persistence