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Rates of combination antiretroviral treatment change in Australia, 1997-2000
journal contribution
posted on 2002-01-01, 00:00 authored by K Petoumenos, David AustinDavid Austin, D Baker, M Block, K Brown, A Carr, D Cooper, D Couldwell, D Ellis, R Finlayson, C Gorton, A Gowers, N Keeffe, J Kidd, M Law, M T Liang, R McFarlane, K Mutimer, J Miller, C O'Connor, The Australian HIV Observational DatabaseObjective. To estimate the rate of combination antiretroviral treatment change and factors associated with combination antiretroviral treatment change among patients recruited in the Australian HIV Observational Database (AHOD). Methods. Analyses were based on patients in the AHOD who had commenced combination antiretroviral treatment after 1 January 1997. Combination antiretroviral treatment change was defined as the addition or change of at least one antiretroviral drug. A random-effect Poisson regression model was used to assess factors associated with increased rates of combination antiretroviral treatment change. Results. A total of 596 patients in the AHOD were included in the analysis, with a median follow-up of 2.3 years. The overall rate of antiretroviral treatment change in this group was 0.45 combinations per year. In a multivariate analysis, a low CD4 count (< 200 cells/μL) at baseline was associated with an increased rate of treatment change [rate ratio (RR) = 1.43; 95% confidence interval (CI), 1.13, 1.80; P = 0.003)]. Combinations including a nonnucleoside reverse transcriptase inhibitor were also associated with slower rates of change than treatment combinations including a protease inhibitor (RR = 0.64, 95% CI, 0.51, 0.80, P < 0.001). Conclusion. Initiating combination antiretroviral at a CD4 cell count < 200 cells/μL may be associated with poorer patient outcomes. However, the possibility that clinician or patient concerns about low immunological status led to faster rates of treatment change in this group cannot be discounted.
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Journal
HIV medicineVolume
3Issue
1Pagination
28 - 36Publisher
WileyLocation
Chichester, Eng.Publisher DOI
ISSN
1464-2662Language
engPublication classification
C1.1 Refereed article in a scholarly journalCopyright notice
2002, British HIV AssociationUsage metrics
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