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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Four years data of raltegravir-based salvage therapy in HIV-1-infected, treatment-experienced patients: The SALIR-E Study
International Journal of Antimicrobial Agents, Volume 43, No. 2, Year 2014
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Description
Apart from the BENCHMRK study, there are no large observational experiences describing the long-term efficacy and safety of rescue regimens for human immunodeficiency virus type 1 (HIV-1) infection. Antiretroviral-experienced patients with detectable viraemia starting a raltegravir (RAL)-based regimen between March 2007 and June 2009 were consecutively enrolled and followed for ≥4 years. Data were censored at Week 206 for homogeneity. Of 333 patients, 258 (77.5%) were still on RAL-based therapy at Week 206, and 241 had undetectable HIV-1 RNA (73% in intention-to-treat analysis). Of the 75 subjects who discontinued RAL therapy, 36 were lost to follow-up, 15 changed their regimen due to virological failure, 2 simplified their regimen stopping RAL, 9 stopped all antiretrovirals and 13 died. Overall, 100 subjects (30.0%) had at least one detectable viraemia, but only 32 (9.6%) had true viral failure. Seventeen patients continued their failing regimen. 'Blips' were experienced by 53 patients (15.9%), whilst 15 (4.5%) had confirmed viral rebound due to adherence issues and were re-suppressed upon treatment re-introduction. In a multivariate analysis of predictors of interruption or failure, each baseline HIV-1 RNA log10 increase was associated with an adjusted hazard ratio for failure of 1.6; having more than 13 previous treatment courses also emerged as a predictor. Overall, adverse events were rare (n = 64), with 13 deaths. Tumours were mainly early events, often fatal (7/15), mainly non-Hodgkin's lymphomas (8), followed by hepatocarcinoma (2). RAL proved effective and well tolerated in this cohort, and few patients experienced viral failure after 4 years. © 2013 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.
Authors & Co-Authors
Capetti, Amedeo Ferdinando
Italy, Milan
Ospedale Luigi Sacco - Polo Universitario
Meraviglia, Paola
Italy, Milan
Ospedale Luigi Sacco - Polo Universitario
Landonio, Simona
Italy, Milan
Ospedale Luigi Sacco - Polo Universitario
Sterrantino, Gaetana
Italy, Florence
Azienda Ospedaliera Careggi
Di Biagio, Antonio
Italy, Genoa
Irccs San Martino Polyclinic Hospital
Lo Caputo, Sergio
Italy, Florence
Azienda Sanitaria Di Firenze
Ammassari, Adriana
Italy, Rome
Irccs Istituto Nazionale Malattie Infettive Lazzaro Spallanzani
Menzaghi, Barbara
Italy, Varese
Azienda Ospedaliera Ospedale Di Circolo e Fondazione Macchi Di Varese
de Socio, Giuseppe Vittorio Luigi
Italy, Perugia
Azienda Ospedaliera Di Perugia
Soria, A.
Italy, Monza
Azienda Ospedaliera San Gerardo Monza
Meschiari, Marianna
Italy, Modena
Azienda Ospedaliero - Universitaria Di Modena
Celesia, Benedetto Maurizio
Italy, Catania
Università Degli Studi Di Catania
Carenzi, Laura
Italy, Milan
Ospedale Luigi Sacco - Polo Universitario
Ricci, Elena Delfina
Italy, Milan
Ospedale Luigi Sacco - Polo Universitario
Rizzardini, Giuliano
Italy, Milan
Ospedale Luigi Sacco - Polo Universitario
Statistics
Citations: 14
Authors: 15
Affiliations: 14
Identifiers
Doi:
10.1016/j.ijantimicag.2013.10.013
ISSN:
18727913
Research Areas
Cancer
Environmental
Infectious Diseases
Study Design
Cohort Study