Lars Jørgen Østergaard

Uptake and effectiveness of two-drug compared with three-drug antiretroviral regimens among HIV-positive individuals in Europe

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

  • Bastian Neesgaard, Department of Infectious Diseases, CHIP, Section 2100, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
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  • Annegret Pelchen-Matthews, London Ctr Nanotechnol, University College London, University of London
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  • Lene Ryom, Department of Infectious Diseases, CHIP, Section 2100, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
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  • Eric Florence, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
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  • Lars Peters, Department of Infectious Diseases, CHIP, Section 2100, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
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  • Ashley Roen, London Ctr Nanotechnol, University College London, University of London
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  • Veronika Svedhem, Unit of Infectious Diseases and Dermatology, Department of Medicine, Karolinska Institutet, and Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.
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  • Amanda Clarke, Royal Sussex County Hospital, Brighton, UK.
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  • Thomas Benfield, Department of Clinical Microbiology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark; Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
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  • Viktar Mitsura, Gomel State Medical University, Gomel, Belarus.
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  • Santiago Moreno, Medical Oncology Department, Ramón y Cajal University Hospital, Madrid, Spain.
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  • Marek Beniowski, Szpital Specjalistyczny, Chorzow, Poland.
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  • Josip Begovac, University Hospital of Infectious Diseases, Zagreb, Croatia.
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  • Raimonda Matulionyte, Vilnius University, Faculty of Medicine, Vilnius University Hospital Santaros Klinikos.
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  • Tatyana Trofimova, Novgorod Centre for AIDS Prevention and Control, Russia.
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  • Daniel Elbirt, Clinical Genetics Institute, Kaplan Medical Center, Rehovot 76100, Israel; Hebrew University and Hadassah Medical Center, Jerusalem, Israel.
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  • Mariana Kundro, Hospital J.M. Ramos Mejia, Buenos Aires, Argentina.
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  • Vincenzo Vullo, Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy; Istituto Pasteur-Fondazione Cenci Bolognetti, Rome, Italy.
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  • Georg Behrens, Medizinische Hochschule Hannover, Hannover, Germany.
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  • Therese Staub, DECCP; Pediatric Clinic/CHL, Luxembourg, Luxembourg Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg.
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  • Leigh Ragone, ViiV Healthcare, RTP, North Carolina, USA.
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  • Vani Vannappagari, ViiV Healthcare, RTP, North Carolina, USA.
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  • Jens Lundgren, Department of Infectious Diseases, CHIP, Section 2100, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
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  • Amanda Mocroft, London Ctr Nanotechnol, University College London, University of London
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  • EuroSIDA study

OBJECTIVE: To assess the use of two-drug antiretroviral regimens (2DR) and virologic and immunologic outcomes compared with three-drug regimens (3DR) in the EuroSIDA cohort.

DESIGN: Multicentre, prospective cohort study.

METHODS: Logistic regression was used to analyse the uptake and outcomes among HIV-positive individuals who started or switched to a 2DR compared with those on a 3DR. Virologic outcomes were assessed on-treatment as the proportion of individuals with controlled viral load (<400 copies/ml), or with a composite modified FDA snapshot endpoint (mFDA), with mFDA success defined as controlled viral load at 6 months or 12 months for individuals with a known viral load, no regimen changes, AIDS or death. Immunologic response was defined as a 100 cells/μl or a 25% increase in CD4 cell counts from baseline.

RESULTS: Between 1 July 2010 and 31 December 2016, 423 individuals started or switched to a 2DR (eight antiretroviral-naive) and 4347 started a 3DR (566 naive). Individuals on 2DR tended to have suppressed viral load, higher CD4 cell counts and more comorbidities at baseline compared with those on 3DR. There were no differences in the proportions of individuals who obtained on-treatment or mFDA success, and no significant differences in the adjusted odds ratios for mFDA success or immunologic responses between the 2DR and 3DR groups at 6 months or 12 months.

CONCLUSION: In routine clinical practice, 2DR were largely used for virologically suppressed individuals with higher cumulative exposure to antiretrovirals and comorbidities. Virologic and immunologic outcomes were similar among those on 2DR or 3DR, although confounding by indication cannot be fully excluded due to the observational nature of the study.

Original languageEnglish
JournalAIDS (London, England)
Volume33
Issue13
Pages (from-to)2013-2024
Number of pages12
ISSN0269-9370
DOIs
Publication statusPublished - Nov 2019

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