Improved Virologic Response After Triple Class Failure in HIV

Improvement in viral load suppression, decrease in rate of AIDS likely due to new meds

MONDAY, Oct. 10 (HealthDay News) -- There has been a considerable improvement in viral load suppression and a decrease in the rate of AIDS for patients with HIV who had triple-class virological failure (TCVF) with the three original classes of antiretroviral drugs between 2000 and 2009, according to a study published online Oct. 10 in The Lancet Infectious Diseases.

Dominique Costagliola, Ph.D., from Institut National de la Santé et de la Rechere Médicale in Paris, and colleagues investigated the trends in virological and clinical outcomes for 2,476 participants from the Pursuing Later Treatment Option II project who started antiretroviral therapy for HIV from 1998, but had TCVF and at least one viral load measurement from 2000 to 2009. TCVF was defined as failure to at least two nucleoside reverse transcriptase inhibitors, one non-nucleoside reverse transcriptase inhibitor, and one ritonavir-boosted protease inhibitor. Virological suppression and incidence of AIDS or death after TCVF were assessed after multivariable adjustments.

The investigators found that the percentage of patients who had post-TCVF virological response increased from 19.5 percent in 2000 to 57.9 percent in 2009. The incidence of AIDS per 100 person-years decreased significantly from 7.7 between 2000 and 2002 to 2.3 in 2008 and 1.2 in 2009. Mortality per 100 person-years decreased significantly from 4.0 between 2000 and 2002 to 1.9 in 2007 and 1.4 in 2008. However this trend did not remain significant after adjustments.

"[This improvement] was probably mainly driven by availability of newer drugs with better tolerability and ease of use and small cross-resistance profiles," the authors write.

Several authors disclosed financial relationships with the pharmaceutical industry.

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