Analysis of the discontinuation of protease inhibitor therapy in routine clinical practice

被引:14
作者
Ferrer, E
Consiglio, E
Podzamczer, D
Grau, I
Ramon, JM
Perez, JL
Gudiol, F
机构
[1] Univ Barcelona, Infect Dis Serv, E-08907 Barcelona, Spain
[2] Univ Barcelona, Prevent Serv, Barcelona, Spain
[3] Univ Barcelona, Microbiol Serv, Barcelona, Spain
关键词
D O I
10.1080/00365549950164030
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
We evaluated the frequency of and reasons for discontinuation of protease inhibitor therapy in a cohort of HIV-infected patients in a prospective observational study. We included 230 HIV-infected patients who had started protease inhibitor therapy between November 1996 and July 1997, Mean baseline CD4 count was 138 cells/mu l and HIV-RNA 4.5 log10. Forty-five percent of patients had prior AIDS and 77% had been treated with nucleoside analogues. Saquinavir-treated patients were at a less advanced stage of HIV disease. Overall, 41.3% of patients discontinued therapy, and their last HIV-RNA measured higher than that of patients who continued therapy: 4.07 vs. 2.70 log10 (p < 0.0001). Reasons for discontinuation of therapy mere poor adherence (including abandonment) (18.6%), drug intolerance (12.1%), virological failure (7%) and physician decision (3.5%). In a multivariate model, factors associated with drug discontinuation were not taking indinavir (OR 0.26, 95% CI 0.12-0.59) and being pretreated with nucleoside analogues (OR 3.42, 95% CI 1.58-7.42). We concluded that in routine clinical practice a high proportion of patients discontinued protease inhibitors during the first 6 months of therapy, the main reason being the patient's own decision (abandonment or poor adherence). Psychological support and counselling are warranted in patients when initiating protease inhibitor therapy.
引用
收藏
页码:495 / 499
页数:5
相关论文
共 30 条
  • [1] Protease inhibitors in the homeless
    Bangsberg, D
    Tulsky, JP
    Hecht, FM
    Moss, AR
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1997, 278 (01): : 63 - 65
  • [2] BURGER DM, 1999, 6 C RETR OPP INF CHI
  • [3] Antiretroviral therapy for HIV infection in 1998 - Updated recommendations of the International AIDS Society USA panel
    Carpenter, CCJ
    Fischl, MA
    Hammer, SM
    Hirsch, MS
    Jacobsen, DM
    Katzenstein, DA
    Montaner, JSG
    Richman, DD
    Saag, MS
    Schooley, RT
    Thompson, MA
    Vella, S
    Yeni, PG
    Volberding, PA
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1998, 280 (01): : 78 - 86
  • [4] A syndrome of peripheral lipodystrophy, hyperlipidaemia and insulin resistance in patients receiving HIV protease inhibitors
    Carr, A
    Samaras, K
    Burton, S
    Law, M
    Freund, J
    Chisholm, DJ
    Cooper, DA
    [J]. AIDS, 1998, 12 (07) : F51 - F58
  • [5] A SHORT-TERM STUDY OF THE SAFETY, PHARMACOKINETICS, AND EFFICACY OF RITONAVIR, AN INHIBITOR OF HIV-1 PROTEASE
    DANNER, SA
    CARR, A
    LEONARD, JM
    LEHMAN, LM
    GUDIOL, F
    GONZALES, J
    RAVENTOS, A
    RUBIO, R
    BOUZA, E
    PINTADO, V
    AGUADO, AG
    DELOMAS, JG
    DELGADO, R
    BORLEFFS, JCC
    HSU, A
    VALDES, JM
    BOUCHER, CAB
    COOPER, DA
    GIMENO, C
    CLOTET, B
    TOR, J
    FERRER, E
    MARTINEZ, PL
    MORENO, S
    ZANCADA, G
    ALCAMI, J
    NORIEGA, AR
    PULIDO, F
    GLASSMAN, HN
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1995, 333 (23) : 1528 - 1533
  • [6] HIV-1 protease inhibitors - A review for clinicians
    Deeks, SG
    Smith, M
    Holodniy, M
    Kahn, JO
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1997, 277 (02): : 145 - 153
  • [7] FATKENHEUER G, 1997, AIDS, V11, pF1131
  • [8] A trial comparing nucleoside monotherapy with combination therapy in HIV-infected adults with CD4 cell counts from 200 to 500 per cubic millimeter
    Hammer, SM
    Katzenstein, DA
    Hughes, MD
    Gundacker, H
    Schooley, RT
    Haubrich, RH
    Henry, WK
    Lederman, MM
    Phair, JP
    Niu, M
    Hirsch, MS
    Merigan, TC
    Blaschke, TF
    Simpson, D
    McLaren, C
    Rooney, J
    Salgo, M
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1996, 335 (15) : 1081 - 1090
  • [9] A PILOT-STUDY TO EVALUATE THE DEVELOPMENT OF RESISTANCE TO NEVIRAPINE IN ASYMPTOMATIC HUMAN IMMUNODEFICIENCY VIRUS-INFECTED PATIENTS WITH CD4 CELL COUNTS OF GREATER-THAN-500/MM(3) - AIDS CLINICAL-TRIALS GROUP PROTOCOL-208
    HAVLIR, D
    MCLAUGHLIN, MM
    RICHMAN, DD
    [J]. JOURNAL OF INFECTIOUS DISEASES, 1995, 172 (05) : 1379 - 1383
  • [10] HECHT FM, 1998, 5 C RETR OPP INF CHI