Highly active antiretroviral therapy discontinuation time is associated with therapeutic failure among human immunodeficiency virus (<scp>HIV</scp>)‐infected immigrant adults: A cohort study from a Peruvian referral hospital during the Venezuelan exodus
Journal
Tropical Medicine & International Health
ISSN
1360-2276
1365-3156
Date Issued
2023
Author(s)
Kirbeliz Rebolledo‐Ponietsky
Ali Al‐kassab‐Córdova
Aldo Lucchetti‐Rodríguez
Alfonso J. Rodriguez‐Morales
Edward Mezones‐Holguín
Type
Resource Types::text::journal::journal article
Abstract
<jats:title>Abstract</jats:title><jats:sec><jats:title>Objective</jats:title><jats:p>To evaluate the association between Highly Active Antiretroviral Therapy (HAART) discontinuation time and therapeutic failure (TF) in Venezuelan immigrants with HIV that restart HAART.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We carried out a retrospective cohort study in a large hospital in Peru. We included Venezuelan immigrants who restarted HAART and were followed over at least 6 months. The primary outcome was TF. Secondary outcomes were immunologic (IF), virologic (VF) and clinical (CF) failures. The exposure variable was HAART discontinuation, categorised as no discontinuation, less than 6 months, and 6 months or more. We applied generalised linear models Poisson family with robust standard errors to calculate crude (cRR) and adjusted (aRR) relative risks by statistical and epidemiological criteria.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>We included 294 patients, 97.2% were males, and the median age was 32 years. Out of all the patients, 32.7% discontinued HAART for less than 6 months, 15.0% discontinued for more than 6 months and the remaining 52.3% did not discontinue. The cumulative incidence of TF was 27.9%, 24.5% in VF, 6.0% in IF and 6.0% in CF. Compared with non‐discontinued HAART patients, the discontinuation for less than 6 months (aRR = 1.98 [95% CI: 1.27<jats:bold>–</jats:bold>3.09]) and from 6 months to more (aRR = 3.17 [95% CI: 2.02<jats:bold>–</jats:bold>4.95]) increased the risk of TF. Likewise, treatment discontinuation of up to 6 months (aRR = 2.32 [95% CI: 1.40<jats:bold>–</jats:bold>3.84]) and from 6 months to more (aRR = 3.93 [95% CI: 2.39<jats:bold>–</jats:bold>6.45]) increased the risk of VF.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>HAART discontinuation increases the probability of TF and VF in Venezuelan immigrants.</jats:p></jats:sec>
Cite this document
Rebolledo‐Ponietsky, K., Al‐kassab‐Córdova, A., Lucchetti‐Rodríguez, A., Cabieses, B., Rodriguez‐Morales, A. J., & Mezones‐Holguín, E. (2023). Highly active antiretroviral therapy discontinuation time is associated with therapeutic failure among human immunodeficiency virus (hiv)‐infected immigrant adults: A cohort study from a Peruvian referral hospital during the Venezuelan exodus. Tropical Medicine & International Health, 28(8), 641-652. https://doi.org/10.1111/tmi.13909
Subjects
emigrants and immigrants
;
highly active antiretroviral therapy
;
hiv
;
peru
;
treatment failure
;
adult
;
anti-hiv agents
;
antiretroviral therapy, highly active
;
cd4 lymphocyte count
;
cohort studies
;
emigrants and immigrants
;
female
;
hiv
;
hiv infections
;
hospitals
;
humans
;
male
;
peru
;
retrospective studies
;
viral load
;
peru
;
anti human immunodeficiency virus agent
;
adult
;
antimicrobial activity
;
cohort analysis
;
disease treatment
;
emigration
;
health risk
;
hospital sector
;
human immunodeficiency virus
;
immigrant population
;
infectious disease
;
adult
;
article
;
cohort analysis
;
controlled study
;
cumulative incidence
;
drug withdrawal
;
exposure variable
;
female
;
highly active antiretroviral therapy
;
human
;
human immunodeficiency virus
;
immigrant
;
lack of drug effect
;
major clinical study
;
male
;
migrant
;
nonhuman
;
outcome assessment
;
patient referral
;
peru
;
probability
;
retrospective study
;
risk factor
;
treatment failure
;
cd4 lymphocyte count
;
cohort analysis
;
highly active antiretroviral therapy
;
hospital
;
human immunodeficiency virus
;
human immunodeficiency virus infection
;
peru
;
virus load