TY - JOUR
T1 - Factors associated with the number of drugs in darunavir/cobicistat regimens
AU - Martinez, Esteban
AU - Negredo, Eugenia
AU - Knobel, Hernando
AU - Ocampo, Antonio
AU - Sanz, Jose
AU - Garcia-Fraile, Lucio
AU - Martin-Carbonero, Luz
AU - Lozano, Fernando
AU - Gonzalez-Domenech, Carmen M.
AU - Gutierrez, Mar
AU - Montero, Marta
AU - Boix, Vicente
AU - Payeras, Antoni
AU - Torralba, Miguel
AU - Gonzalez-Cordon, Ana
AU - Moreno, Ana
AU - Alejos, Belen
AU - Perez-Elias, Maria J.
AU - Martinez, Esteban
AU - Pérez, M. Jesús
AU - Alejos, Belen
AU - Negredo, Eugenia
AU - Knobel, Hernando
AU - Ocampo, Antonio
AU - Sanz, Jose
AU - De Los Santos, Ignacio
AU - Carbonero, Luz Martin
AU - Lozano, Fernando
AU - González-Domenech, Carmen Mariá
AU - Gutierrez, Mar
AU - Montero, Marta
AU - Boix, Vicente
AU - Payeras, Antonio
AU - Torralba, Miguel
AU - Ribera, Esteban
AU - Galindo, Maria J.
AU - Vilanova, Lucia
AU - Garcia-Fraile, Lucio
AU - De La Fuente Moral, Sara
AU - De Lomas, Jose Garcia
AU - Lozano, Fernando
AU - Garciá, Maria Gracia Mateo
AU - Pitatch, Maria Tasias
AU - Martinez, Marcos Diez
AU - Raya, Manuel
AU - Troya, Jesus
AU - Sepúlveda, Maria Antonia
AU - Del Campo, Santos
AU - Vivancos, M. Jesús
AU - Ayerbe, Cristina Gomez
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Background: Darunavir/cobicistat can be used as mono, dual, triple or more than triple therapy. Objectives: To assess factors associated with the number of drugs in darunavir/cobicistat regimens. Methods: A nationwide retrospective cohort study of consecutive HIV-infected patients initiating darunavir/cobicistat in Spain from July 2015 to May 2017. Baseline characteristics, efficacy and safety at 48 weeks were compared according to the number of drugs used. Results: There were 761 patients (75% men, 98% were antiretroviral-experienced, 32% had prior AIDS, 84% had HIV RNA <50 copies/mL and 88% had ≥200 CD4 cells/mm3) who initiated darunavir/cobicistat as mono (n=308, 40%), dual (n=173, 23%), triple (n=253, 33%) or four-drug (n=27, 4%) therapy. Relative to monotherapy, triple therapy was more common in men aged <50 years, with prior AIDS and darunavir plus ritonavir use, and with CD4 cells <200/mm3 and with detectable viral load at initiation of darunavir/cobicistat; dual therapy was more common with previous intravenous drug use, detectable viral load at initiation of darunavir/cobicistat and no prior darunavir plus ritonavir; and four-drug therapy was more common with prior AIDS and detectable viral load at initiation of darunavir/cobicistat. Monotherapy and dual therapy showed a trend to better virological responses than triple therapy. CD4 responses and adverse effects did not differ among regimens. Discussion: Darunavir/cobicistat use in Spain has been tailored according to clinical characteristics of HIV-infected patients. Monotherapy and dual therapy have been common and preferentially addressed to older patients with a better HIV status, suggesting that health issues other than HIV infection may have been strong determinants of its prescription.
AB - Background: Darunavir/cobicistat can be used as mono, dual, triple or more than triple therapy. Objectives: To assess factors associated with the number of drugs in darunavir/cobicistat regimens. Methods: A nationwide retrospective cohort study of consecutive HIV-infected patients initiating darunavir/cobicistat in Spain from July 2015 to May 2017. Baseline characteristics, efficacy and safety at 48 weeks were compared according to the number of drugs used. Results: There were 761 patients (75% men, 98% were antiretroviral-experienced, 32% had prior AIDS, 84% had HIV RNA <50 copies/mL and 88% had ≥200 CD4 cells/mm3) who initiated darunavir/cobicistat as mono (n=308, 40%), dual (n=173, 23%), triple (n=253, 33%) or four-drug (n=27, 4%) therapy. Relative to monotherapy, triple therapy was more common in men aged <50 years, with prior AIDS and darunavir plus ritonavir use, and with CD4 cells <200/mm3 and with detectable viral load at initiation of darunavir/cobicistat; dual therapy was more common with previous intravenous drug use, detectable viral load at initiation of darunavir/cobicistat and no prior darunavir plus ritonavir; and four-drug therapy was more common with prior AIDS and detectable viral load at initiation of darunavir/cobicistat. Monotherapy and dual therapy showed a trend to better virological responses than triple therapy. CD4 responses and adverse effects did not differ among regimens. Discussion: Darunavir/cobicistat use in Spain has been tailored according to clinical characteristics of HIV-infected patients. Monotherapy and dual therapy have been common and preferentially addressed to older patients with a better HIV status, suggesting that health issues other than HIV infection may have been strong determinants of its prescription.
UR - http://www.scopus.com/inward/record.url?scp=85076447217&partnerID=8YFLogxK
U2 - 10.1093/jac/dkz399
DO - 10.1093/jac/dkz399
M3 - Artículo
C2 - 31586414
AN - SCOPUS:85076447217
VL - 75
SP - 208
EP - 214
IS - 1
ER -