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Effectiveness and Risk Factors for Virological Outcome of Raltegravir-Based Therapy for Treatment-Experienced HIV-Infected Patients.

Effectiveness and Risk Factors for Virological Outcome of Raltegravir-Based Therapy for Treatment-Experienced HIV-Infected Patients.
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Mata-Marín JA, Smeke AE, Rodriguez MR, Chávez-García M, Banda-Lara MI, Rios AM, Nuñez-Rodríguez N, Domínguez-Hermosillo JC, Sánchez AC, Juarez-Kasusky I, Herrera JE, Ramírez JL, Gaytán-Martínez J,


Mata-Marín JA, Smeke AE, Rodriguez MR, Chávez-García M, Banda-Lara MI, Rios AM, Nuñez-Rodríguez N, Domínguez-Hermosillo JC, Sánchez AC, Juarez-Kasusky I, Herrera JE, Ramírez JL, Gaytán-Martínez J, (click to view)

Mata-Marín JA, Smeke AE, Rodriguez MR, Chávez-García M, Banda-Lara MI, Rios AM, Nuñez-Rodríguez N, Domínguez-Hermosillo JC, Sánchez AC, Juarez-Kasusky I, Herrera JE, Ramírez JL, Gaytán-Martínez J,

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Drugs in R&D 17(1) 225-231 doi 10.1007/s40268-017-0174-z

Abstract
OBJECTIVE
We evaluated the effectiveness of a raltegravir (RAL)-containing regimen plus an optimized background regimen in HIV-1 highly treatment-experienced patients.

DESIGN
A retrospective cohort, multicentre study was conducted.

METHODS
Adult (>16 years old) HIV treatment-experience patients starting therapy with a RAL-containing regimen were included. Effectiveness was evaluated as the percentage of patients with an undetectable HIV-1 RNA viral load (<50 and <200 copies/mL) after 48 weeks, and changes in CD4+ cell counts. We evaluated the risk factors associated with treatment failure. RESULTS
Of the 107 patients in the cohort, 86% were men, the median age was 45 years [interquartile range (IQR) 40-52] and the median number of previous regimens was six (IQR 4-7). After 48 weeks of treatment, 73% (IQR 63-80%) of patients (n = 78) had a viral load of <50 copies/mL and 85% (IQR 77-90%) (n = 91) had <200 copies/mL. In a logistic regression model, risk factors associated with a virological outcome of HIV-1 RNA of <200 copies/mL were age >40 years [odds ratio (OR) 5.61; 95% confidence interval (CI) 1.61-18.84; P = 0.006] and use of tenofovir in the regimen (OR 0.16; 95% CI 0.03-0.80; P = 0.026).

CONCLUSIONS
In this Mexican cohort, RAL achieved high rates of virological suppression and an increase in CD4+ cell count in highly treatment-experienced patients infected with HIV-1. Age >40 years was associated with a good virological outcome, contrary to tenofovir use, which was associated with a poor virological outcome.

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