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2020-07-01Zeitschriftenartikel
Treatment modification after starting cART in people living with HIV: retrospective analysis of the German ClinSurv HIV Cohort 2005–2017
dc.contributor.authorStecher, Melanie
dc.contributor.authorSchommers, Philipp
dc.contributor.authorKollan, Christian
dc.contributor.authorStoll, Matthias
dc.contributor.authorKuhlendahl, Frieder
dc.contributor.authorStellbrink, Hans-Jürgen
dc.contributor.authorWasmuth, Jan-Christian
dc.contributor.authorStephan, Christoph
dc.contributor.authorHamacher, Laura
dc.contributor.authorLehmann, Clara
dc.contributor.authorBoesecke, Christoph
dc.contributor.authorBogner, Johannes
dc.contributor.authorEsser, Stefan
dc.contributor.authorFritzsche, Carlos
dc.contributor.authorHaberl, Annette
dc.contributor.authorSchürmann, Dirk
dc.contributor.authorDegen, Olaf
dc.contributor.authorHorst, Heinz-August
dc.contributor.authorHoffmann, Christian
dc.contributor.authorJensen, Björn
dc.contributor.authorSchwarze-Zander, Carolynne
dc.contributor.authorPlatten, Martin
dc.contributor.authorFätkenheuer, Gerd
dc.contributor.authorSchmidt, Daniel
dc.contributor.authorGunsenheimer-Bartmeyer, Barbara
dc.contributor.authorVehreschild, Jörg Janne
dc.date.accessioned2023-12-12T16:04:16Z
dc.date.available2023-12-12T16:04:16Z
dc.date.issued2020-07-01none
dc.identifier.other10.1007/s15010-020-01469-6
dc.identifier.urihttp://edoc.rki.de/176904/11416
dc.description.abstractObjective Combination antiretroviral therapy (cART) has markedly increased survival and quality of life in people living with HIV. With the advent of new treatment options, including single-tablet regimens, durability and efficacy of first-line cART regimens are evolving. Methods We analyzed data from the prospective multicenter German Clinical Surveillance of HIV Disease (ClinSurv) cohort of the Robert-Koch Institute. Kaplan–Meier and Cox proportional hazards models were run to examine the factors associated with treatment modification. Recovery after treatment initiation was analyzed comparing pre-cART viral load and CD4+ T-cell counts with follow-up data. Results We included 8788 patients who initiated cART between 2005 and 2017. The sample population was predominantly male (n = 7040; 80.1%), of whom 4470 (63.5%) were reporting sex with men as the transmission risk factor. Overall, 4210 (47.9%) patients modified their first-line cART after a median time of 63 months (IQR 59–66). Regimens containing integrase strand transfer inhibitors (INSTI) were associated with significantly lower rates of treatment modification (adjusted hazard ratio 0.44; 95% CI 0.39–0.50) compared to protease inhibitor (PI)-based regimens. We found a decreased durability of first-line cART significantly associated with being female, a low CD4+ T-cell count, cART initiation in the later period (2011–2017), being on a multi-tablet regimen (MTR). Conclusions Drug class and MTRs are significantly associated with treatment modification. INSTI-based regimens showed to be superior compared to PI-based regimens in terms of durability.eng
dc.language.isoengnone
dc.publisherRobert Koch-Institut
dc.rights(CC BY 3.0 DE) Namensnennung 3.0 Deutschlandger
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/de/
dc.subjectHIVeng
dc.subjectcARTeng
dc.subjecttreatment modificationeng
dc.subjectfirst-line regimeneng
dc.subject.ddc610 Medizin und Gesundheitnone
dc.titleTreatment modification after starting cART in people living with HIV: retrospective analysis of the German ClinSurv HIV Cohort 2005–2017none
dc.typearticle
dc.identifier.urnurn:nbn:de:0257-176904/11416-0
dc.type.versionpublishedVersionnone
local.edoc.container-titleInfectionnone
local.edoc.container-issn1439-0973none
local.edoc.pages11none
local.edoc.type-nameZeitschriftenartikel
local.edoc.container-typeperiodical
local.edoc.container-type-nameZeitschrift
local.edoc.container-urlhttps://link.springer.com/journal/15010none
local.edoc.container-publisher-nameSpringer Naturenone
local.edoc.container-volume48none
local.edoc.container-issue5none
local.edoc.container-reportyear2020none
local.edoc.container-firstpage723none
local.edoc.container-lastpage733none
dc.description.versionPeer Reviewednone

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