2026-05-22T11:08:18Zhttps://repisalud.isciii.es/rest/oai/requestoai:repisalud.isciii.es:20.500.12105/271452026-01-15T01:18:20Zcom_20.500.12105_2052com_20.500.12105_2051col_20.500.12105_19608
Repisalud
author
Alejos, Belén
author
Suárez-García, Inés
author
Rava, Marta
author
Bautista-Hernández, Azucena
author
Gutierrez, Félix
author
Dalmau, David
author
Sagastagoitia, Iñigo
author
Rivero, Antonio
author
Moreno, Santiago
author
Jarrin Vera, Inmaculada
author
CoRIS
2026-01-14T18:38:08Z
2026-01-14T18:38:08Z
2020-10-01
Belén Alejos, Inés Suárez-García, Marta Rava, Azucena Bautista-Hernández, Félix Gutierrez, David Dalmau, Iñigo Sagastagoitia, Antonio Rivero, Santiago Moreno, Inma Jarrín, CoRIS. Effectiveness and safety of first-line antiretroviral regimens in clinical practice: a multicentre cohort study. Journal of Antimicrobial Chemotherapy, Volume 75, Issue 10, October 2020, Pages 3004–3014, https://doi.org/10.1093/jac/dkaa246.
10.1093/jac/dkaa246
Journal of Antimicrobial Chemotherapy
32667674
https://hdl.handle.net/20.500.12105/27145
Objectives: We compared 48 week effectiveness and safety of first-line antiretroviral regimens. Methods: We analysed HIV treatment-naive adults from the Cohort of the Spanish HIV/AIDS Research Network (CoRIS) starting the most commonly used antiretroviral regimens from 2014 to 2018. We used multivariable regression models to assess the impact of initial regimen on: (i) viral suppression (VS) (viral load <50 copies/mL); (ii) change in CD4 cell count; (iii) CD4/CD8 normalization (>0.4 and >1); (iv) CD4 percentage normalization (>29%); (v) multiple T-cell marker recovery (MTMR: CD4 > 500 cells/mm3 plus CD4 percentage >29% plus CD4/CD8 > 1); (vi) lipid, creatinine and transaminase changes; and (vii) discontinuations due to adverse events (AE). Results: Among 3945 individuals analysed, the most frequently prescribed regimens were ABC/3TC/DTG (34.0%), TAF/FTC/EVG/CBT (17.2%), TDF/FTC + DTG (11.9%), TDF/FTC/EVG/CBT (11.7%), TDF/FTC/RPV (11.5%), TDF/FTC + bDRV (8.3%) and TDF/FTC + RAL (5.3%). At 48 weeks, 89.7% of individuals achieved VS with no significant differences by initial regimen. CD4 mean increase was 257.8 (249.3; 266.2) cells/mm3, and it was lower with TAF/FTC/EVG/CBT and TDF/FTC/RPV compared with ABC/3TC/DTG. CD4 percentage normalization was less likely with TAF/FTC/EVG/CBT, and MTMR was less likely with TAF/FTC/EVG/CBT and TDF/FTC + RAL. The proportion of discontinuations due to AE was higher with TDF/FTC + bDRV (9.7%), followed by TDF/FTC/EVG/CBT (9.5%) and TDF/FTC + DTG (7.9%). Compared with ABC/3TC/DTG, cholesterol and LDL mean increases were higher with TAF/FTC/EVG/CBT and lower with TDF/FTC + DTG, TDF/FTC/RPV and TDF/FTC + RAL. Higher mean increases in triglycerides were significantly associated with TAF/FTC/EVG/CBT. Regimens containing DTG showed higher creatinine increases. Conclusions: The significantly greater immunological response and safety of some combinations may be useful for making decisions when initiating treatment.
eng
Effectiveness and safety of first-line antiretroviral regimens in clinical practice: a multicentre cohort study.
research article
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