AIDSWEEKLY Plus; Monday, August 8, 2005
Staff Medical Writers

"To analyze the incidence, prevalence, and predictors for development of triple-class antiretroviral drug failure (TCF) in individuals infected with HIV," a population based "observational cohort study from January 1, 1995 to December 31, 2003" focused "on all 2722 recipients of highly active antiretroviral therapy (HAART) in Denmark."

"We used person-years analysis, Kaplan-Meier survival curves and Cox regression analysis. TCF was defined as a minimum of 120 days with viral load >1000 copies/ml on treatment with each of the three major drug classes," scientists writing in the journal AIDS report.

"We observed 177 TCFs, yielding a crude incidence rate (IR) of 1.8 per 100 person-years [95% confidence interval (Cl), 1.6-2.1]. Seven years after initiation of HAART, 17.2% (95% Cl, 14.5-20.5) of antiretroviral (ART)-experienced patients, but only 7.0% (95% Cl, 4.3-11.2) of ART-naive patients were estimated to have failed," said N. Lohse and coworkers at Odense University Hospital.

"After an initial rise," wrote the authors, "the IR from the third to the sixth year of HAART declined significantly for ART-experienced patients [incidence rate ratio (IRR), 0.80 per year (95% Cl, 0.660.97); p=0.022], and nonsignificantly for ART-naive patients [IRR, 0.79 per year (95% Cl, 0.53-1.18); p=0.255].

"The IR for all patients being followed each year declined from 1997 to 2003 [IRR, 0.88 (95% Cl, 0.81-0.96); p=0.002]. The prevalence of TCF remained stable at less than 7% after 2000."

Lohse continued, "Predictors of TCF at commencement of HAART were a CD4 cell count below 200, a previous AIDS-defining event, previous antiretroviral exposure, earlier year of HAART initiation, and young age."

"The risk of TCF is declining in Denmark and the prevalence remains stable," concluded researchers.

Lohse and colleagues published their study in AIDS (Declining risk of triple-class antiretroviral drug failure in Danish HIV-infected individuals. AIDS. 2005 May 20;19(8):815-22.

Additional information can be obtained by contacting N. Lohse, Odense University of Hospital, Dept. Infectious Disease, Sdr Blvd. 29, DK-5000 Odense, Denmark.

The publisher of the journal AIDS can be contacted at: Lippincott Williams & Wilkins, 530 Walnut St., Philadelphia, PA 19106-3621, USA.

Keywords: Odense, Denmark, HIV/AIDS, HAART, Epidemiology, Treatment Failure, Viral Inhibition.

This article was prepared by AIDS Weekly editors from staff and other reports.

Reference

Lohse N, Obel N, Kronborg G, et al., Declining risk of triple-class antiretroviral drug failure in Danish HIV-infected individuals., AIDS. 2005 May 20;19(8):815-22.

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