Comparison of cumulative viraemia following treatment initiation with different antiretroviral regimens: a real‐life study in Brazil

• Published in: Journal of the International AIDS Society 2019-11, Vol.22 (11), p.e25397-n/a
• Main Authors: Pascom, Ana R, Pinho, Rosana EGG, Rick, Fernanda, Veras, Nazle MC, Perini, Filipe de Barros, Meireles, Mariana V, Pereira, Gerson F, Benzaken, Adele S, Avelino‐Silva, Vivian I
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adult; Age; AIDS; AIDS/HIV; Anti-HIV Agents - therapeutic use; Anti-Retroviral Agents - therapeutic use; Antiretroviral drugs; antiretroviral regimen; antiretroviral treatment; Antiviral agents; Atazanavir; Brazil; CD4 Lymphocyte Count; Child; Clinical trials; Cohort Studies; Comparative analysis; cumulative viremia; Development and progression; Dolutegravir; Drug therapy; Efavirenz; efficacy; Ethnicity; Female; Highly active antiretroviral therapy; HIV; HIV infection; HIV Infections - drug therapy; HIV-1; Human immunodeficiency virus; Humans; Lamivudine; Male; Males; Measurement; Medical research; Middle Aged; Patient compliance; Public health; real‐life; Retrospective Studies; Short Report; Short Reports; Studies; Viremia; Viremia - drug therapy; Virus diseases; Young Adult
• ISSN: 1758-2652; 1758-2652
• DOI: 10.1002/jia2.25397

Introduction The relative efficacy of different antiretroviral (ART) regimens has been extensively evaluated in the context of clinical trials, using HIV viral load (VL) measurements at pre‐specified timepoints after ART onset. However, data from real‐life studies using combined longitudinal measurements of cumulative viraemia are scarce. This study aimed to address the independent effect of different ART regimens on HIV cumulative viraemia over the first 12 months after treatment initiation, using programmatic data from the Ministry of Health of Brazil. Methods Retrospective cohort study analysing cumulative viraemia under the most frequently used ART regimens in Brazil (tenofovir, lamivudine and dolutegravir (regimen 1); tenofovir, lamivudine and efavirenz (regimen 2); tenofovir, lamivudine and ritonavir‐boosted atazanavir (regimen 3)). Results and Discussion We included 112,243 patients >12 years old who received their first ART prescription between January 2014 and August 2017. Univariate analysis indicated that cumulative viraemia was significantly lower in patients receiving regimen 1 as compared with those receiving regimens 2 or 3 (p