Toxicity Responsible for Much HAART Switching -- HIV/AIDS INFO AND UPDATES

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Date Posted: 12:07:54 05/16/02 Thu
Author: Anonymous
Subject: Toxicity Responsible for Much HAART Switching

Toxicity Responsible for Much HAART Switching

Reuters Health Information 2002. � 2002 Reuters Ltd
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Introduction
NEW YORK (Reuters Health) Apr 24 - As is the case in first-line highly active antiretroviral therapy (HAART), toxicity is the main reason for much second-line HAART switching, according to Dutch researchers, who point out that an initial toxicity-driven switch increases the risk of subsequent switching.

Dr. Jeanne P. Dieleman, of Erasmus University Medical Centre Rotterdam, and colleagues studied 659 men and 116 women who switched their initial protease inhibitor (PI)-containing HAART regimen without having had virological failure.

The researchers, whose findings appeared in the March 29th issue of AIDS, note that at 1 year, the overall cumulative incidence of switches of the second regimen was 53%. In total, 24% were due to toxicity. Compared to those who had switched regimens for other reasons, patients who had switched from the first HAART because of toxicity were more than twice as likely (relative risk 2.5) of switching the second HAART.

However, switching from a PI to nevirapine, rather than an alternative PI, and continuing on the other antiretrovirals cut the relative risk of subsequent switching because of toxicity to 0.2.

The researchers point out that this was so "even in patients with prior toxicity," and conclude that the effect should be taken into account when formulating toxicity-management guidelines for patients on PI-based HAART.

AIDS 2002;16:737-745.
http://www.medscape.com/viewarticle/432602_print

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