TY - JOUR
T1 - Long-term virological suppression on first-line efavirenz+tenofovir+emtricitabine/lamivudine for HIV-1
AU - long-term virological suppression working group for the collaboration of observational HIV epidemiological research Europe (COHERE) in EuroCord
AU - Stirrup, Oliver
AU - EuroCoord, Long-Term Virological Suppression Working Group for the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) in
PY - 2019/3/15
Y1 - 2019/3/15
N2 - Evaluate long-term rates of virological failure and treatment interruption for people living with HIV (PLWHIV) with viral suppression on first-line efavirenz+tenofovir disoproxil fumarate+emtricitabine/lamivudine (EFV+TDF+FTC/3TC), and compare these according to patient characteristics.Methods:PLWHIV enrolled in the Collaboration of Observational HIV Epidemiological Research Europe cohort collaboration, who started first-line EFV+TDF+FTC/3TC at age at least 16 years and had viral suppression (<200 copies/ml) within 9 months were included. Rates of virological failure (≥200 copies/ml) and (complete) treatment interruption were estimated according to years since initial suppression. We used Poisson regression to examine associations of baseline characteristics with rates of virological failure or treatment interruption.Results:Among 19527 eligible PLWHIV with median (interquartile range) follow-up 3.7 (2.0-5.6) years after initial viral suppression, the estimated rate of the combined incidence of virological failure or treatment interruption fell from 9.0/100 person-years in the first year to less than 4/100 person-years beyond 3 years from suppression; considering only those remaining on EFV+TDF+FTC/3TC, the combined rate dropped from 8.2/100 person-years in the first year to less than 3.5/100 person-years beyond 3 years. PLWHIV with injecting drug-related or heterosexual transmission were at higher risk of virological failure or treatment interruption, as were those of Black ethnicity. PLWHIV aged less than 35 years were at higher risk of virological failure and treatment interruption.Conclusion:PLWHIV starting first-line EFV+TDF+FTC/3TC had low rates of virological failure and treatment interruption up to 10 years from initial suppression. Demographic characteristics can be used to identify subpopulations with higher risks of these outcomes.
AB - Evaluate long-term rates of virological failure and treatment interruption for people living with HIV (PLWHIV) with viral suppression on first-line efavirenz+tenofovir disoproxil fumarate+emtricitabine/lamivudine (EFV+TDF+FTC/3TC), and compare these according to patient characteristics.Methods:PLWHIV enrolled in the Collaboration of Observational HIV Epidemiological Research Europe cohort collaboration, who started first-line EFV+TDF+FTC/3TC at age at least 16 years and had viral suppression (<200 copies/ml) within 9 months were included. Rates of virological failure (≥200 copies/ml) and (complete) treatment interruption were estimated according to years since initial suppression. We used Poisson regression to examine associations of baseline characteristics with rates of virological failure or treatment interruption.Results:Among 19527 eligible PLWHIV with median (interquartile range) follow-up 3.7 (2.0-5.6) years after initial viral suppression, the estimated rate of the combined incidence of virological failure or treatment interruption fell from 9.0/100 person-years in the first year to less than 4/100 person-years beyond 3 years from suppression; considering only those remaining on EFV+TDF+FTC/3TC, the combined rate dropped from 8.2/100 person-years in the first year to less than 3.5/100 person-years beyond 3 years. PLWHIV with injecting drug-related or heterosexual transmission were at higher risk of virological failure or treatment interruption, as were those of Black ethnicity. PLWHIV aged less than 35 years were at higher risk of virological failure and treatment interruption.Conclusion:PLWHIV starting first-line EFV+TDF+FTC/3TC had low rates of virological failure and treatment interruption up to 10 years from initial suppression. Demographic characteristics can be used to identify subpopulations with higher risks of these outcomes.
KW - antiretroviral therapy
KW - viral failure
KW - viral rebound
KW - viral suppression
KW - virological control
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U2 - 10.1097/QAD.0000000000002126
DO - 10.1097/QAD.0000000000002126
M3 - Article
C2 - 30829745
AN - SCOPUS:85062401971
VL - 33
SP - 745
EP - 751
JO - AIDS
JF - AIDS
SN - 0269-9370
IS - 4
ER -