Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Risk of extensive virological failure to the three original antiretroviral drug classes over long-term follow-up from the start of therapy in patients with HIV infection: an observational cohort study
Lancet, Volume 370, No. 9603, Year 2007
Notification
URL copied to clipboard!
Description
Background: The long-term durability of viral-load suppression provided by the three original antiretroviral drugs is not well characterised. We estimated the proportion of patients who had extensive triple-class failure during long-term follow-up and examined characteristics associated with an increased rate of failure. Methods: 7916 patients who started antiretroviral therapy with three or more drugs were followed up from the time that therapy started until the last viral-load measure. Extensive triple-class virological failure was defined by failure of three subclasses of nucleoside reverse transcriptase inhibitors, a non-nucleoside reverse transcriptase inhibitor, and a ritonavir-boosted protease inhibitor. Findings: 167 patients developed extensive triple-class failure during 27 441 person-years of follow-up. The Kaplan-Meier estimate for the cumulative risk of extensive triple-class failure was 9·2% by 10 years (95% CI 5·0-13·4). There was evidence that this rate has decreased over time (adjusted hazard ratio 0·86 [0·77-0·96] per year more recent; p=0·006). Of the 167 patients with extensive triple-class failure, 101 (60%) subsequently had at least one viral load less than 50 copies per mL. The risk of death by 5 years from the time of extensive triple-class failure was 10·6% (2·4-18·8, nine deaths). Interpretation: We have shown that extensive virological failure of the three main classes of drugs occurs slowly in routine clinical practice. This finding has implications for the planning of treatment programmes in developing countries, where additional drugs outside these classes are unlikely to be available for some time. © 2007 Elsevier Ltd. All rights reserved.
Authors & Co-Authors
Phillips, Andrew N.
United Kingdom, London
Ucl Medical School
Leen, Clifford L.S.
United Kingdom, Edinburgh
Western General Hospital
Wilson, Alan C.
United Kingdom, Edinburgh
Western General Hospital
Anderson, Jane
United Kingdom, London
Homerton University Hospital Nhs Foundation Trust
Dunn, David T.
United Kingdom, London
Medical Research Council
Schwenk, Achim
United Kingdom, London
North Middlesex University Hospital
Orkin, Chloë M.
United Kingdom, London
Barts Health Nhs Trust
Hill, Teresa
United Kingdom, London
Ucl Medical School
Fisher, Martin J.
United Kingdom, Worthing
University Hospitals Sussex Nhs Foundation Trust
Walsh, John Christopher
United Kingdom, London
St Mary's Hospital
Morris, Lynn G.
United Kingdom, London
Ucl Medical School
Bansi-Matharu, Loveleen K.
United Kingdom, London
Ucl Medical School
Gazzard, Brian George L.
United Kingdom, London
Chelsea and Westminster Hospital Nhs Foundation Trust
Easterbrook, Philippa Jane
United Kingdom, London
King's College Hospital
Gilson, Richard John Cary
United Kingdom, London
University College London
Johnson, Margaret A.
United Kingdom, London
Ucl Medical School
Sabin, Caroline Anne
United Kingdom, London
Ucl Medical School
Statistics
Citations: 61
Authors: 17
Affiliations: 11
Identifiers
Doi:
10.1016/S0140-6736(07)61815-7
ISSN:
01406736
Research Areas
Environmental
Infectious Diseases
Study Design
Cohort Study
Study Approach
Quantitative