Treatment limitations imposed by antiretroviral therapy: a comparison of first line regimens containing boosted-protease inhibitors and non-nucleoside reverse transcriptase inhibitors

Resource type
Thesis type
(Project) M.P.H.
Date created
2009
Authors/Contributors
Author: Mtambo, Andy
Abstract
NNRTI-based ART is mainly used as first-line treatment for HIV in resource-limited settings. Anecdotal evidence suggests a greater chance of resistance from failing NNRTI-based regimens compared to boosted-PI. Development of resistance mutations among individuals who initiated ART with boosted-PIs were compared with those who initiated ART with NNRTIs in a retrospective study of ART-naïve individuals in BC, Canada. A total of 1666 participants initiated ART with 818 (49.1%) on NNRTI-based regimen. Participants who initiated NNRTI-based regimens had more resistance mutation compared to those on boosted-PI (40.3% vs. 27.3%, p <0.001). After switching therapy to second line, the odds of achieving two consecutive pVLs of <50 copies/ml after switching was inversely associated with NNRTI use in the initial ART regimen (OR: 0.32; 95% CI: 0.11 - 0.97). The use of NNRTI-based first-line regimens was associated with more ART drug resistance patterns which limit the number of available second-line drug choices.
Document
Copyright statement
Copyright is held by the author.
Scholarly level
Supervisor or Senior Supervisor
Thesis advisor: Hogg, Robert S.
Language
English
Member of collection
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etd4483_AMtambo.pdf 598.78 KB