DI-027 Analysis of the durability of antiretroviral monotherapy in hiv infected patients
2017
Background One of the main objectives in the adequacy of HIV antiretroviral treatment is to find the drug or set of drugs that allow the best results to be obtained for the patient and to try to support this medication over time. Since the introduction of antiretroviral monotherapy in HIV there have been many studies examining the efficacy and safety of treatment, but to date, few have studied duration of monotherapy. Purpose To analyse survival after monotherapy (MT) in HIV patients and to perform a descriptive analysis for subgroups of factors associated with MT. Material and methods An observational, retrospective, analytical study was conducted in HIV patients treated with MT during 2014. Selection of patients and analysis of their antiretroviral medication were reviewed with the platform Farmatools (MT type and possible change). Clinical and demographic data (age, sex, coinfection with HCV and HBV) were obtained from the electronic health record through Mambrino XXI. We performed an analysis of survival and defined the event as ‘changing MT to double therapy (DT) or triple therapy (TT)’. We obtained data by subgroup mortality tables through the SPPS V.21 statistical programme. Results 79 patients (70.9% men) were included, mean age 51 years (44–70). With respect to antiretroviral MT: 84.4% of patients (n=67) were taking darunavir/ritonavir (DRV/r) and 15.2% (n=12) were taking liponavir/ritonavir (LPN/r). No patient was coinfected with HBV but 30 patients were HCV coinfected. Statistical analysis showed that the median survival time was: 54 months in men and 48 months in women (p=0.750). 47.27 months in HCV coinfected patients and 54 months in non-coinfected patients (p=0.315). 54 months in patients who were treated with DRV/r and 51 months with LPN/r (p=0.071). In 19 patients (24.1%) the following event occurred: 16.45% (n=13) changed to TT and 7.59% (n=6) to DT. 76% of patients who were maintained on MT (n=60) switched to DRV/cobicistat. Conclusion Median survival after MT was reasonably positive, with a tendency for better results in men not coinfected with HCV and in patients with DRV/r, although these result were not statistically significant. Further studies are required to justify the reason for change from MT to BT or TT and the benefit of a regimen against another to generalise the results. References and/or acknowledgements Special thanks to Dr Martinez Sesmero. No conflict of interest
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