Incidence of discontinuation or modification of antiretroviral therapy due to toxicity of treatment stratified by age

• Autores: Mercedes Manzano García, María de las Aguas Robustillo Cortés, María Rosa Cantudo Cuenca, Yolanda Borrego Izquierdo, Carmen V. Almeida-González, Ramón A. Morillo Verdugo
• Localización: European journal of clinical pharmacy: atención farmacéutica, ISSN 2385-409X, Vol. 19, Nº. 1, 2017, págs. 16-23
• Idioma: inglés
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• Resumen

  • Purpose: To evaluate the incidence of discontinuing or modifying of Active Antiretroviral Therapy (ART) due to toxicity of treatment stratified by age in a real practice cohort. Methods: Retrospective observational study conducted from I-January-2010 until 3 l-December-2014 of HIV-positive patients over 18 years receiving ART. The outpatient dispensing records and the toxicity database of our Pharmaceutical Care Consultation (PCC) was applied. The variables analyzed were: sex, age, average plasma viral load (copies/mL); T-CD4 levels (cells/mm3); immu-novirological control; acquisition risk factor; naïve patient or pretreated; type of toxicity; year of appearance of toxicity; ART type and incidence of modification or discontinuance of the ART. Patients were stratified into three age groups: young (18-35 years); adults (36-49 years); and advanced age (greater than or equal to 50 years). Results: 347 patients were included in the study. The most common type of ART associated with an increased risk of toxicity in the group of young patients was the combination of NRTI+NNRTI in 69.1% (No. = 38), mainly presenting neurological toxicity (40%; No. = 22), while in the group of adult patients was NRTI+PI/r (51%; No. = 100) (p = 0.006), presenting predominantly gastrointestinal toxicity (26.5%; No. = 52). The association NRTI+NNRTI was the most commonly occurring in 53.1% (No. = 51) of advance age patients. Incidences of discontinuation or modification of ART were higher than other types of toxicity in the group of adults in 2013 with a rate of 12.88 per 100 patients (95% CI: 10.4-17.5). Conclusion: The rate of modification or discontinuation of ART is moderate, particularly in young age patients the last years