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Non European HIV Patients on HAART in a Dutch Cohort Show Increased
Risk of Early Virological Failure
The aim of the current study
was to compare early and late responses to HAART in European and non-European HIV-1 infected
patients in a Dutch cohort.
The investigators
retrospectively analyzed the response to HAART of 216 previously
treatment-naive HIV-1-infected patients using the University Medical
Centre Utrecht HIV database.
African (n=51), Asian (n=7),
and Central/South American (n=6) patients were classified
as non-European, and others as European (n=152).
Early virological
failure
was defined as a viral load that remained above 400 HIV-1 RNA copies/mL
after 6 months of treatment with HAART.
Late-phase failure
was determined in patients who were successfully treated in the
early phase and was defined as two consecutive viral load measurements
above 400 copies/mL, a new AIDS-defining
event or death.
Results
· In
the early phase, four of 152 (2.6%) European and eight of 64 (12.5%)
non-European patients failed HAART.
· A
significant increased risk of virological failure in the early phase
of treatment was observed for non-Europeans as compared to Europeans.
· Low serum drug
levels in the absence of resistant virus were often seen at the
time of early failure.
· No
difference in late-phase failure was observed between the two groups
(adjusted hazard ratio 0.6; 95% confidence interval 0.3-1.2).
According
to the study authors, non-European patients had a 4.6 times higher
risk of virological failure than their European counterparts in
the first 6 months of treatment with HAART.
The
authors conclude, “This failure seemed to be associated with low
serum drug levels at the time of failure. However, if HAART was
successful in the early phase, response rates in the late phase
were similar for Europeans and non-Europeans.”
09/23/05
Reference
J
B van den Berg and others. Increased risk of early
virological failure in non-European HIV-1-infected patients in a
Dutch cohort on highly active antiretroviral therapy. HIV Medicine 6(5): 299-306. September 2005.
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