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Effectiveness of etravirine-based therapy for treatment-experienced HIV-infected patients.

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Huerta García G, Mata-Marín JA, Domínguez-Hermosillo JC, Chavez-García M, Banda-Lara MI, Nuñez-Rodríguez N, Cruz-Herrera JE, Sandoval-Ramírez JL, Villagómez-Ruiz A, Manjarrez-Tellez B, Gaytan-Martínez JE,


Huerta García G, Mata-Marín JA, Domínguez-Hermosillo JC, Chavez-García M, Banda-Lara MI, Nuñez-Rodríguez N, Cruz-Herrera JE, Sandoval-Ramírez JL, Villagómez-Ruiz A, Manjarrez-Tellez B, Gaytan-Martínez JE, (click to view)

Huerta García G, Mata-Marín JA, Domínguez-Hermosillo JC, Chavez-García M, Banda-Lara MI, Nuñez-Rodríguez N, Cruz-Herrera JE, Sandoval-Ramírez JL, Villagómez-Ruiz A, Manjarrez-Tellez B, Gaytan-Martínez JE,

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Journal of infection in developing countries 2016 06 3010(6) 605-11 doi 10.3855/jidc.7512

Abstract
INTRODUCTION
Treatment options are limited for HIV-1-infected individuals who have received extensive previous antiretroviral therapy. ETV has shown significant clinical benefits in treatment-experienced HIV-1+ patients with antiretroviral resistance. The aim of this study was to evaluate the effectiveness of ETV plus optimized background regimen in real-life conditions in a cohort of highly HIV-1 antiretroviral-experienced patients.

METHODOLOGY
Retrospective cohort of treatment-experienced HIV-1-infected adults with virological failure who started therapy with an ETV-containing regimen. The effectiveness was evaluated using HIV-1 RNA viral load and changes in CD4+ cell count after 48 weeks of treatment.

RESULTS
Forty-two patients ≥ 16 years of age were included; 74% were men, and the median age was 45 years (IQR 41-53). All participants had prior non-nucleoside reverse transcriptase inhibitor use (55% nevirapine, 83%, efavirenz, and 28% both). Baseline median HIV-1 RNA viral load was 15,598 copies/mL (IQR 2651-84,175) and CD4+ cell count was 276 cells/mL (IQR 155-436). After 48 weeks of treatment, 90.5% (95% CI 78-96) of patients had HIV-1 RNA viral load < 200 copies/mL and 76% (95% CI 61-86) had < 50 copies/mL. CD4+ cell counts increased from baseline to 48 weeks of treatment to a median of 407 cells/mL (IQR 242-579); p < 0.001. Virological outcome was associated with virological failure at baseline HIV-1 RNA viral load ≥ 100,000 copies/mL (OR 7.6; 95% CI 1.2-44.80; p = 0.025). CONCLUSIONS
Our study provides clinically important evidence of the effectiveness and safety of ETV in highly antiretroviral-experienced HIV-1-infected patients.

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