Influencia de las pruebas de resistencias a antirretrovirales sobre la efectividad del tratamiento en pacientes con infección por VIH y fracaso virológico
2007
Objective: The objective of this study is to determine the
influence of antiretroviral-resistance tests on the suppression of
HIV (< 400 copies/mL) in patients with virological failure who
require an alternative antiretroviral treatment.
Method: A retrospective observational study on cohorts of
adult patients. Two groups were defined: cases in which the prescription
of antiretrovirals was based on resistance tests (group A),
and controls in which no such test was performed (group B). Each
group was divided into two sub-groups according to the number of
changes in treatment: first treatment change (A1 and B1); a subsequent
change (A2 and B2). The main variable was defined as
the proportion of patients with negative viral load (< 400
copies/mL) at the third month of treatment; secondary variables
were the proportion of patients with negative viral load at the
sixth month and an average variation in the CD4 level at the third
and sixth months after this change.
Results: A total of 152 patients were included in this study,
59 in group A and 93 in group B (control). No differences were
found in the stage of the disease at the time of administering an
alternative treatment. 59.3% of the patients in group A and
47.3% of the patients in group B had suppressed the HIV viral
load at the third month, although this difference was not statistically
significant (p = 0.149). No statistically significant differences
were found in the secondary variables.
Conclusions: The use of antiretroviral-resistance tests increased
effectiveness in the response to the selected antiretroviral treatment
in the study group, although we did not obtain significant
differences for the group of patients in which these tests were not
performed.
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