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- Title
Factors associated with the number of drugs in darunavir/cobicistat regimens.
- Authors
Martinez, Esteban; Negredo, Eugenia; Knobel, Hernando; Ocampo, Antonio; Sanz, Jose; Garcia-Fraile, Lucio; Martin-Carbonero, Luz; Lozano, Fernando; Gonzalez-Domenech, Carmen M; Gutierrez, Mar; Montero, Marta; Boix, Vicente; Payeras, Antoni; Torralba, Miguel; Gonzalez-Cordon, Ana; Moreno, Ana; Alejos, Belen; Perez-Elias, Maria J; Group, GeSIDA 9316 CODAR Study; GeSIDA 9316 CODAR Study Group
- Abstract
<bold>Background: </bold>Darunavir/cobicistat can be used as mono, dual, triple or more than triple therapy.<bold>Objectives: </bold>To assess factors associated with the number of drugs in darunavir/cobicistat regimens.<bold>Methods: </bold>A nationwide retrospective cohort study of consecutive HIV-infected patients initiating darunavir/cobicistat in Spain from July 2015 to May 2017. Baseline characteristics, efficacy and safety at 48 weeks were compared according to the number of drugs used.<bold>Results: </bold>There were 761 patients (75% men, 98% were antiretroviral-experienced, 32% had prior AIDS, 84% had HIV RNA <50 copies/mL and 88% had ≥200 CD4 cells/mm3) who initiated darunavir/cobicistat as mono (n=308, 40%), dual (n=173, 23%), triple (n=253, 33%) or four-drug (n=27, 4%) therapy. Relative to monotherapy, triple therapy was more common in men aged <50 years, with prior AIDS and darunavir plus ritonavir use, and with CD4 cells <200/mm3 and with detectable viral load at initiation of darunavir/cobicistat; dual therapy was more common with previous intravenous drug use, detectable viral load at initiation of darunavir/cobicistat and no prior darunavir plus ritonavir; and four-drug therapy was more common with prior AIDS and detectable viral load at initiation of darunavir/cobicistat. Monotherapy and dual therapy showed a trend to better virological responses than triple therapy. CD4 responses and adverse effects did not differ among regimens.<bold>Discussion: </bold>Darunavir/cobicistat use in Spain has been tailored according to clinical characteristics of HIV-infected patients. Monotherapy and dual therapy have been common and preferentially addressed to older patients with a better HIV status, suggesting that health issues other than HIV infection may have been strong determinants of its prescription.
- Subjects
SPAIN; RITONAVIR; DARUNAVIR; HIV infections; VIRAL load; AIDS; HIV-positive persons; OLDER patients; ANTI-HIV agents; RESEARCH; COMBINATION drug therapy; AGE distribution; RESEARCH methodology; RETROSPECTIVE studies; MEDICAL cooperation; EVALUATION research; COMPARATIVE studies; HIV
- Publication
Journal of Antimicrobial Chemotherapy (JAC), 2020, Vol 75, Issue 1, p208
- ISSN
0305-7453
- Publication type
journal article
- DOI
10.1093/jac/dkz399