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Rates of combination antiretroviral treatment change in Australia, 1997–2000
Author(s) -
Kathy Petoumenos,
Danielle Austin,
David Baker,
Michael S. Block,
Katie Brown,
Andrew Carr,
David A. Cooper,
Deborah L. Couldwell,
Deborah A. Ellis,
Robert Finlayson,
Carla Gorton,
Andrew Gowers,
N. Keeffe,
J Kidd,
Matthew Law,
M.T. Liang,
Robert M. McFarlane,
K Mutimer,
John P. Miller,
Catherine O’Connor,
Dick Quan,
P. J. Rooney,
Simeon I. Taylor,
Don Smith,
David Wheatley,
Peter Knibbs,
Sarah Huffam,
Stephanie Morgan,
Jan Savage,
David L. Bradford,
John Chuah,
B. Dickson,
W. Fankhauser,
G. G. Lister,
H Magon,
David N. Orth,
Mary C. Rawlinson,
Hugo Rée,
David Sowden,
A.S. Walker,
Claire Wilson,
J. Anderson,
Bal J,
Jad Daye,
Beng Eu,
C.K. Fairely,
Jennifer Hoy,
Clare McCormack,
George McGovern,
Ruth McNair,
Nicholas Medland,
Anne M Mijch,
Moore Rd,
Amy Pierce,
Norman Roth,
Darren Russell,
Stefan Strecker,
Kerrie Watson,
Hayley Wood,
A Cain,
Matthew French,
S. Mallal,
Donald M. Maxwell,
Christopher Moore,
J. Skett
Publication year - 2002
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1046/j.1464-2662.2001.00094.x
Subject(s) - medicine , confidence interval , poisson regression , rate ratio , reverse transcriptase inhibitor , antiretroviral treatment , antiretroviral therapy , viral load , human immunodeficiency virus (hiv) , immunology , population , environmental health
Objective To estimate the rate of combination antiretroviral treatment change and factors associated with combination antiretroviral treatment change among patients recruited in the Australian HIV Observational Database (AHOD). Methods Analyses were based on patients in the AHOD who had commenced combination antiretroviral treatment after 1 January 1997. Combination antiretroviral treatment change was defined as the addition or change of at least one antiretroviral drug. A random‐effect Poisson regression model was used to assess factors associated with increased rates of combination antiretroviral treatment change. Results A total of 596 patients in the AHOD were included in the analysis, with a median follow‐up of 2.3 years. The overall rate of antiretroviral treatment change in this group was 0.45 combinations per year. In a multivariate analysis, a low CD4 count (< 200 cells/μL) at baseline was associated with an increased rate of treatment change [rate ratio (RR)=1.43; 95% confidence interval (CI), 1.13, 1.80; P =0.003)]. Combinations including a nonnucleoside reverse transcriptase inhibitor were also associated with slower rates of change than treatment combinations including a protease inhibitor (RR=0.64, 95% CI, 0.51, 0.80, P < 0.001). Conclusion Initiating combination antiretroviral at a CD4 cell count < 200 cells/μL may be associated with poorer patient outcomes. However, the possibility that clinician or patient concerns about low immunological status led to faster rates of treatment change in this group cannot be discounted.