The Role of Toxicity-Related Regimen Changes in the Development of Antiretroviral Resistance
Authors
Nevin, Christa R.Ye, Jiatao
Aban, Inmaculada B.
Mugavero, Michael J.
Jackson, David
Lin, Hui-Yi
Allison, Jeroan J.
Raper, James L.
Saag, Michael S.
Willig, James H.
UMass Chan Affiliations
Department of Quantitative Health ServicesDocument Type
Journal ArticlePublication Date
2011-03-21Keywords
Anti-Retroviral AgentsDrug Resistance, Viral
Biostatistics
Epidemiology
Health Services Research
Virus Diseases
Metadata
Show full item recordAbstract
In an effort to evaluate factors associated with the development of antiretroviral (ARV) resistance, we assessed the prevalence of toxicity-related regimen changes and modeled its association to the subsequent development of ARV resistance in a cohort of treatment-naive individuals initiating ARV therapy (ART). A retrospective analysis of patients initiating ART was conducted at the UAB 1917 Clinic from 1 January 2000 to 30 September 2007. Cox proportional hazards models were fit to identify factors associated with the development of resistance to >/=1 ARV drug class. Among 462 eligible participants, 14% (n=64) developed ARV resistance. Individuals with >/=1 toxicity-related regimen change (HR=3.94, 95% CI=1.09-14.21), initiating ART containing ddI or d4T (4.12, 1.19-14.26), and from a minority race (2.91, 1.16-7.28) had increased risk of developing resistance. Achieving virologic suppression within 12 months of ART initiation (0.10, 0.05-0.20) and higher pretreatment CD4 count (0.85 per 50 cells/mm(3), 0.75-0.96) were associated with decreased hazards of resistance. Changes in ART due to drug intolerance were associated with the subsequent development of ARV resistance. Understanding the role of ARV drug selection and other factors associated with the emergence of ARV resistance will help inform interventions to improve patient care and ensure long-term treatment success.Source
AIDS Res Hum Retroviruses. 2011 Mar 21. Link to article on publisher's siteDOI
10.1089/AID.2010.0291Permanent Link to this Item
http://hdl.handle.net/20.500.14038/47872PubMed ID
21342052Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1089/AID.2010.0291