Virologic and immunologic effectiveness at 48 weeks of darunavir-ritonavir- based regimens in treatment-experienced persons living with HIV-1 infection in clinical practice: A multicenter brazilian cohort

• Main Author: Biscione, Fernando Martín
• Publication Date: 2014
• Other Authors: Westin, Mateus Rodrigues, Ribeiro, Karina Mota, Estevam, Denize Lotufo, Cardoso, Sandra Wagner, Tenore, Simone Barros, Neto, Lauro Ferreira Da Silva Pinto, Alencastro, Paulo Ricardo, Suffert, Theodoro Armando, De Moraes, Mônica Jacques, Barbosa, Alexandre Naime [UNESP], Morejón, Karen Mirna Loro, De Arruda, Érico Antônio Gomes, Silveira, Jussara María, Neto, José Luiz Andrade, Greco, Dirceu Bartolomeu, Tupinambás, Unaí
• Format: Article
• Language: eng
• Source: Repositório Institucional da UNESP
• Download full: http://dx.doi.org/10.1177/2325957413502542; http://hdl.handle.net/11449/220043
• topic: antiretroviral; darunavir; HIV; resistance

Introduction: Published data addressing the effectiveness of darunavirritonavir (DRV/r)-based therapy for multiexperienced patients in developing countries are scarce. This study evaluated the 48-week virologic and immunologic effectiveness of salvage therapy based on DRV/r for the treatment of multidrug-experienced HIV-1-infected adults in Brazil. Materials and Methods: A multicenter retrospective cohort study was carried out with multidrug-experienced adults who were on a failing antiretroviral therapy and started a DRV/r-based salvage therapy between 2008 and 2010. The primary effectiveness end point was the proportion of patients with virologic success (plasma HIV-1 RNA <50 copies/mL at week 48). Results: At 48 weeks, 73% of the patients had HIV-RNA <50 copies/mL and a mean increase of 108 CD4 cells/mm3. Higher baseline viral load, lower baseline CD4 count, younger age, and 3 or more DRV/r-associated resistance mutations were significantly predictive of virologic failure. Concomitant use of raltegravir was strongly associated with virologic success. Conclusion: The use of DRV/r-based regimens for salvage therapy is an effective strategy in the clinical care setting of a developing country. © The Author(s) 2013.