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DETERMINANTS OF ANTIRETROVIRAL TREATMENT SUCCESS AND ADHERENCE IN PEOPLE WITH HUMAN IMMUNODEFICIENCY VIRUS TREATED FOR TUBERCULOSIS
Castro, Nathalie de et al. | Data do documento: 2022
Autor(es)
Castro, Nathalie de
Chazallon, Corine
N'takpe, Jean-Baptiste
Timana, Isabel
Escada, Rodrigo
Wagner, Sandra
Messou, Eugène
Eholie, Serge
Bhatt, Nilesh
Khosa, Celso
Laureillard, Didier
Chau, Giang do
Veloso, Valdiléa G.
Delaugerre, Constance
Anglaret, Xavier
Molina, Jean-Michel
Grinsztejn, Beatriz
Marcy, Olivier
Afiliação
Bordeaux Population Health Centre. Research Institute for Sustainable Development (IRD) EMR 271. National Institute for Health and Medical Research (INSERM) UMR 1219. University of Bordeaux. Bordeaux, France / Infectious Diseases Department. AP-HP-Hôpital Saint-Louis Lariboisière. Paris, France.
Bordeaux Population Health Centre. Research Institute for Sustainable Development (IRD) EMR 271. National Institute for Health and Medical Research (INSERM) UMR 1219. University of Bordeaux. Bordeaux, France.
Bordeaux Population Health Centre. Research Institute for Sustainable Development (IRD) EMR 271. National Institute for Health and Medical Research (INSERM) UMR 1219. University of Bordeaux. Bordeaux, France / Programme PACCI/ANRS Research Center. Abidjan, Côte-d'Ivoire.
Instituto Nacional de Saúde. Marracuene, Mozambique.
Oswaldo Cruz Foundation. National Institute of Infectious Diseases Evandro Chagas. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. National Institute of Infectious Diseases Evandro Chagas. Rio de Janeiro, RJ, Brazil.
Programme PACCI/ANRS Research Center, Abidjan, Côte-d'Ivoire / Centre de Prise en Charge de Recherche et de Formation, CePReF-Aconda-VS. Abidjan, Côte-d'Ivoire.
Programme PACCI/ANRS Research Center, Abidjan, Côte-d'Ivoire / Département de Dermatologie et d'Infectiologie, UFR des Sciences Médicales, Université Félix Houphouët Boigny. Abidjan, Cote d'Ivoire.
Instituto Nacional de Saúde. Marracuene, Mozambique.
Instituto Nacional de Saúde. Marracuene, Mozambique.
Department of Infectious and Tropical Diseases. Nimes University Hospital. Nimes, France / Pathogenesis and Control of Chronic and Emerging Infections. University of Montpellier. Montpellier, France.
Pham Ngoc Thach Hospital. Ho Chi Minh City, Vietnam.
Oswaldo Cruz Foundation. National Institute of Infectious Diseases Evandro Chagas. Rio de Janeiro, RJ, Brazil.
Virology Department. APHP-Hôpital Saint-Louis. Paris, France / INSERM U944. Paris, France / Université de Paris. Paris, France.
Bordeaux Population Health Centre. Research Institute for Sustainable Development (IRD) EMR 271. National Institute for Health and Medical Research (INSERM) UMR 1219. University of Bordeaux. Bordeaux, France.
Infectious Diseases Department. AP-HP-Hôpital Saint-Louis Lariboisière. Paris, France / INSERM U944. Paris, France / Université de Paris. Paris, France.
Oswaldo Cruz Foundation. National Institute of Infectious Diseases Evandro Chagas. Rio de Janeiro, RJ, Brazil.
Bordeaux Population Health Centre. Research Institute for Sustainable Development (IRD) EMR 271. National Institute for Health and Medical Research (INSERM) UMR 1219. University of Bordeaux. Bordeaux, France.
Resumo em Inglês
Background: In people with human immunodeficiency virus [HIV] presenting with advanced disease, rates of virologic success may be lower than expected. The Reflate TB2 trial did not show non-inferiority of raltegravir versus efavirenz in people with HIV (PWH) treated for tuberculosis. We aimed to identify factors associated with virologic success and higher adherence in the trial. Methods: In this analysis, we included participants enrolled in the Reflate TB2 trial with adherence data available. The primary outcome was virologic success (HIV-1 ribonucleic acid [RNA] <50 copies/mL) at week 48, and the secondary outcome was adherence as assessed by the pill count adherence ratio. We used logistic regression to study determinants of virologic success and optimal adherence in 2 separate analyses. Results: Four hundred forty-four participants were included in the present analysis. Over the 48-week follow-up period, 290 of 444 (65%) participants had a pill count adherence ratio ≥95%. At week 48, 288 of 444 (65%) participants were in virologic success. In the multivariate analysis, female sex (adjusted odds ratio [aOR], 1.77; 95% confidence interval [CI], 1.16-2.72; P = .0084), lower baseline HIV-1 RNA levels (<100 000; aOR, 2.29; 95% CI, 1.33-3.96; P = .0087), and pill count adherence ratio ≥95% (aOR, 2.38; 95% CI, 1.56-3.62; P < .0001) were independently associated with virologic success. Antiretroviral pill burden was the only factor associated with pill count adherence ratio ≥95% (OR, 0.81; 95% CI, .71-.92; P = .0018). Conclusions: In PWH with tuberculosis receiving raltegravir or efavirenz-based regimens, female sex, optimal adherence, and baseline HIV-1 RNA <100 000 copies/mL were associated with virologic success, and the number of antiretroviral tablets taken daily was a strong predictor of adherence.
Palavras-chave em inglês
HIV viral load
Adherence
Raltegravir
Tuberculosis
 
Editor
Oxford University Press
Referência
CASTRO, Nathalie de et al. Determinants of Antiretroviral Treatment Success and Adherence in People With Human Immunodeficiency Virus Treated for Tuberculosis. Open Forum Infectious Diseases, v. 9, n. 12, p. 1-9, Nov. 2022.
DOI
10.1093/ofid/ofac628
ISSN
2328-8957