Uptake and virological outcomes of single- versus multi-tablet antiretroviral regimens among treatment-naïve youth in the HIV Research Network

for the HIV Research Network

Research output: Contribution to journalArticle

Abstract

Objectives: Several single-tablet regimens (STRs) are now available and are recommended for first-line antiretroviral therapy (ART); however, STR use for youth with HIV (YHIV) has not been systematically studied. We examined the characteristics associated with initiation of STRs versus multi-tablet regimens (MTRs) and the virological outcomes for youth with nonperinatally acquired HIV (nPHIV). Methods: A retrospective cohort study of nPHIV youth aged 13–24 years initiating ART between 2006 and 2014 at 18 US HIV clinical sites in the HIV Research Network was performed. The outcomes measured were initiation of STRs versus MTRs, virological suppression (VS) at 12 months, and time to VS. Demographic and clinical factors associated with initiation of STR versus MTR ART and VS (< 400 HIV-1 RNA copies/mL) at 12 months after initiation were assessed using multivariable logistic regression. Cox proportional hazards regression was used to assess VS within the first year. Results: Of 987 youth, 67% initiated STRs. Of the 589 who had viral load data at 1 year, 84% of those on STRs versus 67% of those on MTRs achieved VS (P < 0.01). VS was associated with STR use [adjusted odds ratio (AOR) 1.61; 95% confidence interval (CI) 1.01–2.58], white (AOR 2.41; 95% CI 1.13–5.13) or Hispanic (AOR 2.38; 95% CI 1.32–4.27) race/ethnicity, and baseline CD4 count 351–500 cells/μL (AOR 1.94; 95% CI 1.18–3.19) and > 500 cells/μL (AOR 1.76; 95% CI 1.0–3.10). STR use was not associated with a shorter time to VS compared with MTR use [hazard ratio (HR) 1.07; 95% CI 0.90–1.28]. Conclusions: Use of STR was associated with a greater likelihood of sustained VS 12 months after ART initiation in YHIV.

Original languageEnglish (US)
JournalHIV Medicine
DOIs
StateAccepted/In press - Jan 1 2018

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Tablets
HIV
Research
Therapeutics
Cohort Studies
Retrospective Studies
Demography

Keywords

  • adherence
  • antiretroviral therapy
  • HIV
  • single tablet
  • youth

ASJC Scopus subject areas

  • Health Policy
  • Infectious Diseases
  • Pharmacology (medical)

Cite this

@article{47838a577085498292791b1942554076,
title = "Uptake and virological outcomes of single- versus multi-tablet antiretroviral regimens among treatment-na{\"i}ve youth in the HIV Research Network",
abstract = "Objectives: Several single-tablet regimens (STRs) are now available and are recommended for first-line antiretroviral therapy (ART); however, STR use for youth with HIV (YHIV) has not been systematically studied. We examined the characteristics associated with initiation of STRs versus multi-tablet regimens (MTRs) and the virological outcomes for youth with nonperinatally acquired HIV (nPHIV). Methods: A retrospective cohort study of nPHIV youth aged 13–24 years initiating ART between 2006 and 2014 at 18 US HIV clinical sites in the HIV Research Network was performed. The outcomes measured were initiation of STRs versus MTRs, virological suppression (VS) at 12 months, and time to VS. Demographic and clinical factors associated with initiation of STR versus MTR ART and VS (< 400 HIV-1 RNA copies/mL) at 12 months after initiation were assessed using multivariable logistic regression. Cox proportional hazards regression was used to assess VS within the first year. Results: Of 987 youth, 67{\%} initiated STRs. Of the 589 who had viral load data at 1 year, 84{\%} of those on STRs versus 67{\%} of those on MTRs achieved VS (P < 0.01). VS was associated with STR use [adjusted odds ratio (AOR) 1.61; 95{\%} confidence interval (CI) 1.01–2.58], white (AOR 2.41; 95{\%} CI 1.13–5.13) or Hispanic (AOR 2.38; 95{\%} CI 1.32–4.27) race/ethnicity, and baseline CD4 count 351–500 cells/μL (AOR 1.94; 95{\%} CI 1.18–3.19) and > 500 cells/μL (AOR 1.76; 95{\%} CI 1.0–3.10). STR use was not associated with a shorter time to VS compared with MTR use [hazard ratio (HR) 1.07; 95{\%} CI 0.90–1.28]. Conclusions: Use of STR was associated with a greater likelihood of sustained VS 12 months after ART initiation in YHIV.",
keywords = "adherence, antiretroviral therapy, HIV, single tablet, youth",
author = "{for the HIV Research Network} and Griffith, {D. C.} and C. Farmer and Kelly Gebo and Stephen Berry and J. Aberg and Moore, {Richard D} and Gaur, {A. H.} and Mathews, {W. C.} and R. Beil and Korthuis, {P. T.} and Nijhawan, {A. E.} and Rutstein, {R. M.} and Agwu, {Allison Lorna}",
year = "2018",
month = "1",
day = "1",
doi = "10.1111/hiv.12695",
language = "English (US)",
journal = "HIV Medicine",
issn = "1464-2662",
publisher = "Wiley-Blackwell",

}

TY - JOUR

T1 - Uptake and virological outcomes of single- versus multi-tablet antiretroviral regimens among treatment-naïve youth in the HIV Research Network

AU - for the HIV Research Network

AU - Griffith, D. C.

AU - Farmer, C.

AU - Gebo, Kelly

AU - Berry, Stephen

AU - Aberg, J.

AU - Moore, Richard D

AU - Gaur, A. H.

AU - Mathews, W. C.

AU - Beil, R.

AU - Korthuis, P. T.

AU - Nijhawan, A. E.

AU - Rutstein, R. M.

AU - Agwu, Allison Lorna

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objectives: Several single-tablet regimens (STRs) are now available and are recommended for first-line antiretroviral therapy (ART); however, STR use for youth with HIV (YHIV) has not been systematically studied. We examined the characteristics associated with initiation of STRs versus multi-tablet regimens (MTRs) and the virological outcomes for youth with nonperinatally acquired HIV (nPHIV). Methods: A retrospective cohort study of nPHIV youth aged 13–24 years initiating ART between 2006 and 2014 at 18 US HIV clinical sites in the HIV Research Network was performed. The outcomes measured were initiation of STRs versus MTRs, virological suppression (VS) at 12 months, and time to VS. Demographic and clinical factors associated with initiation of STR versus MTR ART and VS (< 400 HIV-1 RNA copies/mL) at 12 months after initiation were assessed using multivariable logistic regression. Cox proportional hazards regression was used to assess VS within the first year. Results: Of 987 youth, 67% initiated STRs. Of the 589 who had viral load data at 1 year, 84% of those on STRs versus 67% of those on MTRs achieved VS (P < 0.01). VS was associated with STR use [adjusted odds ratio (AOR) 1.61; 95% confidence interval (CI) 1.01–2.58], white (AOR 2.41; 95% CI 1.13–5.13) or Hispanic (AOR 2.38; 95% CI 1.32–4.27) race/ethnicity, and baseline CD4 count 351–500 cells/μL (AOR 1.94; 95% CI 1.18–3.19) and > 500 cells/μL (AOR 1.76; 95% CI 1.0–3.10). STR use was not associated with a shorter time to VS compared with MTR use [hazard ratio (HR) 1.07; 95% CI 0.90–1.28]. Conclusions: Use of STR was associated with a greater likelihood of sustained VS 12 months after ART initiation in YHIV.

AB - Objectives: Several single-tablet regimens (STRs) are now available and are recommended for first-line antiretroviral therapy (ART); however, STR use for youth with HIV (YHIV) has not been systematically studied. We examined the characteristics associated with initiation of STRs versus multi-tablet regimens (MTRs) and the virological outcomes for youth with nonperinatally acquired HIV (nPHIV). Methods: A retrospective cohort study of nPHIV youth aged 13–24 years initiating ART between 2006 and 2014 at 18 US HIV clinical sites in the HIV Research Network was performed. The outcomes measured were initiation of STRs versus MTRs, virological suppression (VS) at 12 months, and time to VS. Demographic and clinical factors associated with initiation of STR versus MTR ART and VS (< 400 HIV-1 RNA copies/mL) at 12 months after initiation were assessed using multivariable logistic regression. Cox proportional hazards regression was used to assess VS within the first year. Results: Of 987 youth, 67% initiated STRs. Of the 589 who had viral load data at 1 year, 84% of those on STRs versus 67% of those on MTRs achieved VS (P < 0.01). VS was associated with STR use [adjusted odds ratio (AOR) 1.61; 95% confidence interval (CI) 1.01–2.58], white (AOR 2.41; 95% CI 1.13–5.13) or Hispanic (AOR 2.38; 95% CI 1.32–4.27) race/ethnicity, and baseline CD4 count 351–500 cells/μL (AOR 1.94; 95% CI 1.18–3.19) and > 500 cells/μL (AOR 1.76; 95% CI 1.0–3.10). STR use was not associated with a shorter time to VS compared with MTR use [hazard ratio (HR) 1.07; 95% CI 0.90–1.28]. Conclusions: Use of STR was associated with a greater likelihood of sustained VS 12 months after ART initiation in YHIV.

KW - adherence

KW - antiretroviral therapy

KW - HIV

KW - single tablet

KW - youth

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U2 - 10.1111/hiv.12695

DO - 10.1111/hiv.12695

M3 - Article

C2 - 30561888

AN - SCOPUS:85058674920

JO - HIV Medicine

JF - HIV Medicine

SN - 1464-2662

ER -