Emergence of Drug Resistance in the Swiss HIV Cohort Study Under Potent Antiretroviral Therapy Is Observed in Socially Disadvantaged Patients
| العنوان: | Emergence of Drug Resistance in the Swiss HIV Cohort Study Under Potent Antiretroviral Therapy Is Observed in Socially Disadvantaged Patients |
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| المؤلفون: | Abela, Irene A, Scherrer, Alexandra U, Böni, Jürg, Yerly Ferrillo, Sabine, Klimkait, Thomas, Perreau, Matthieu, Hirsch, Hans H, Furrer, Hansjakob, Calmy, Alexandra, Schmid, Patrick, Cavassini, Matthias, Bernasconi, Enos, Günthard, Huldrych F, Swiss HIV Cohort Study |
| المساهمون: | University of Zurich, Abela, Irene A |
| المصدر: | Clinical Infectious Diseases, Vol. 70, No 2 (2020) pp. 297-303 Abela, Irene A; Scherrer, Alexandra U; Böni, Jürg; Yerly, Sabine; Klimkait, Thomas; Perreau, Matthieu; Hirsch, Hans H; Furrer, Hansjakob; Calmy, Alexandra; Schmid, Patrick; Cavassini, Matthias; Bernasconi, Enos; Günthard, Huldrych F (2020). Emergence of drug resistance in the Swiss HIV Cohort Study under potent antiretroviral therapy is observed in socially disadvantaged patients. Clinical infectious diseases, 70(2), pp. 297-303. Oxford University Press 10.1093/cid/ciz178 <http://dx.doi.org/10.1093/cid/ciz178Test> |
| بيانات النشر: | Oxford University Press (OUP), 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | 10028 Institute of Medical Virology, 0301 basic medicine, Microbiology (medical), Cart, medicine.medical_specialty, Anti-HIV Agents, 030106 microbiology, Drug Resistance, 610 Medicine & health, HIV Infections, Drug resistance, Socioeconomic factors, Vulnerable Populations, 2726 Microbiology (medical), 10234 Clinic for Infectious Diseases, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Humans, Medicine, 030212 general & internal medicine, ddc:616, business.industry, Medical record, virus diseases, 2725 Infectious Diseases, Odds ratio, Mental health, Confidence interval, Antiretroviral therapy, Institutional repository, Infectious Diseases, Risk factors, Case-Control Studies, business, HIV-1 drug resistance, Switzerland, Cohort study |
| الوصف: | BackgroundThe rate of acquired human immunodeficiency virus type 1 (HIV-1) drug resistance (ADR) has fallen dramatically since introduction of combined antiretroviral therapy (cART) in Switzerland. However, clinical experience indicates that there are still patients at risk of newly acquiring drug resistance despite having access to cART. Here, we characterized risk factors for ADR, to improve patient care and prevent emergence of drug resistance and treatment failure.MethodsWe performed a case-control study to identify risk factors for ADR in all patients starting their first cART in the Swiss HIV Cohort Study (SHCS) since 1996. The SHCS is highly representative and includes >75% of patients receiving ART in Switzerland. To this end, we implemented a systematic medical chart review to obtain more detailed information on additional parameters, which are not routinely collected in the SHCS. The collected data were analyzed using univariable and multivariable conditional logistic regression.ResultsWe included in our study 115 cases and 115 matched controls. Unemployment (multivariable odds ratio [mOR], 2.9 [95% confidence interval {CI}, 1.3–6.4]; P = .008), African origin (mOR, 3.0 [95% CI, 1.0–9.2]; P = .047), comedication with anti-infectives (mOR, 3.7 [95% CI, 1.0–12.6]; P = .045), and symptoms of mental illness (mOR, 2.6 [95% CI, 1.2–5.5]; P = .012) were associated with ADR in the multivariable model.ConclusionsAlthough ADR has become very rare with cART due to new potent therapies, patients in socially challenging life situations or presenting with mental health issues are at higher risk for drug resistance. Prompt identification and adequate support of these patients before ADR will prevent treatment failure and HIV-1 transmission. |
| وصف الملف: | ciz178.pdf - application/pdf; application/pdf |
| تدمد: | 1537-6591 1058-4838 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8920663c3c6267ca68e619a4d3a63e12Test https://doi.org/10.1093/cid/ciz178Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....8920663c3c6267ca68e619a4d3a63e12 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15376591 10584838 |
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