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Prevalence of people living with multidrug‐resistant HIV and limited treatment options in Spain.
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- Author(s): Llibre, Josep M.; García, Federico; Blanco, José Luis; Peláez, Esmeralda Palmier; de Cea, Álvaro Mena; Cortés, Luis López; Alonso, Marta Montero; Bernáldez, Miguel Pascual; Schroeder, Melanie; Sánchez, Silvia Esteban; Alcántara, Felipe Rodríguez
- Source:
HIV Medicine; Aug2024, Vol. 25 Issue 8, p946-957, 12p- Subject Terms:
HIV infection epidemiology; MEDICAL care use; CROSS-sectional method; HIV integrase inhibitors; ANTIRETROVIRAL agents; VIRAL load; RESEARCH funding; SALVAGE therapy; SCIENTIFIC observation; LOGISTIC regression analysis; CD4 lymphocyte count; MULTIDRUG resistance; HIV infections; RETROSPECTIVE studies; PROTEASE inhibitors; MEDICAL records; ACQUISITION of data; DRUG interactions; SOCIODEMOGRAPHIC factors; MEDICAL needs assessment; GENETIC mutation; NUCLEOSIDE reverse transcriptase inhibitors; DISEASE progression; SYMPTOMS - Source:
- Additional Information
- Subject Terms:
- Abstract: Objectives: Our aim was to determine the prevalence and characteristics of people with HIV on antiretroviral therapy (ART) with multidrug resistance (MDR; confirmed resistance to three or more [or resistance to two or more plus contraindication to one or more] core ART classes) and limited treatment options (LTOs) in Spain. Methods: This was an observational, retrospective, multicentre, cross‐sectional chart review study undertaken in five reference Spanish centres. Participants were people with HIV on ART with MDR and LTOs (detectable viral load [HIV‐RNA >200 copies/mL], treatment‐limiting drug–drug interaction [DDI], or intolerance precluding the use of one or more ART classes). Prevalence, demographic/clinical characteristics, and treatment options were assessed. Logistic regression analyses were used to identify MDR‐associated variables. Results: Of 14 955 screened people with HIV, 69 (0.46%) presented with MDR and 23 (0.15%) had LTOs. The population analysed was 73.9% male with a median age of 54.0 years; the median time since HIV diagnosis was 26.5 years, and median CD4+ cell count was 511.0 cells/μL. The only factor significantly associated with MDR (univariate analysis) was CD4+ cell count. Injection drug use was the most common transmission route. Comorbidities (mainly endocrine and cardiovascular disorders; 34.8% affecting HIV management) and concomitant treatments were frequent. No recent opportunistic infections were reported. Patients had been exposed to the following ART: nucleoside analogue reverse transcriptase inhibitors (100%), protease inhibitors (95.6%), non‐nucleoside analogue reverse transcriptase inhibitors (87.0%), and integrase strand transfer inhibitors (82.6%). The available fully active drugs were dolutegravir (39.1%), bictegravir (30.4%), and raltegravir (21.7%). Conclusions: The prevalence of people with HIV with MDR and LTOs in Spain is very low, with approximately half of those studied not exhibiting virological suppression. Low CD4+ cell counts were associated with MDR. These findings may help address the impact and treatment needs of these patients and prevent clinical progression and transmission of MDR HIV. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of HIV Medicine is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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