Outcomes and characteristics of patients on protease inhibitors at a tertiary level antiretroviral clinic

Southern African Journal of HIV Medicine

Field Value
Title Outcomes and characteristics of patients on protease inhibitors at a tertiary level antiretroviral clinic
Creator Perks, Michele Reddy, Denasha L. Venter, Francois
Subject medical HIV; NRTI recycling; protease inhibitors; antiretrovirals; South Africa.
Description Background: Protease inhibitors (PIs) have been recommended as World Health Organization second-line antiretroviral therapy (ART) for low- to middle-income countries for two decades. As dolutegravir-based regimens have become widely available, the future role of PIs is uncertain.Objectives: To describe the characteristics of patients on PI-based ART (in first-line and second-line regimens), double-boosted protease inhibitors (DBPI) and patients who received recycled nucleoside reverse transcriptase inhibitors (NRTI) in second-line regimens at a tertiary level ART clinic.Method: We conducted a descriptive retrospective record review of adult patients on PI-based ART who attended Nthabiseng Adult Infectious Diseases Clinic at Chris Hani Baragwanath Academic Hospital in Soweto, South Africa, between January 2021 and April 2022.Results: Of the 900 patients sampled, 543 (60.3%) were female, the median age was 45 and 703 (79.1%) had viral loads (VL) below 1000 copies/mL. In contrast, 21 (58.3%) of 36 vertically infected patients had VLs below 1000 copies/mL. Thirty-seven (4.1%) patients were on DBPIs. The commonest reason for DBPI use in 24 (64.9%) patients was drug resistance test (DRT)-guided switch after virological failure. Forty-nine (5.4%) patients were on recycled NRTIs with no DRT, and 24 (2.6%) patients were on NRTIs to which there was documented resistance. Outcomes for these patients were similar to the total sample.Conclusion: PIs have long been a cornerstone of second-line ART. This study demonstrates the real-world utility of PIs, as well as their disadvantages. There was no difference in the outcomes of patients who received recycled NRTIs in second-line regimens.
Publisher AOSIS
Date 2023-12-21
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — record review
Format text/html application/epub+zip text/xml application/pdf application/pdf
Identifier 10.4102/sajhivmed.v24i1.1536
Source Southern African Journal of HIV Medicine; Vol 24, No 1 (2023); 7 pages 2078-6751 1608-9693
Language eng
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https://sajhivmed.org.za/index.php/hivmed/article/view/1536/3178 https://sajhivmed.org.za/index.php/hivmed/article/view/1536/3179 https://sajhivmed.org.za/index.php/hivmed/article/view/1536/3180 https://sajhivmed.org.za/index.php/hivmed/article/view/1536/3185 https://sajhivmed.org.za/index.php/hivmed/article/view/1536/3181
Coverage Gauteng; South Africa — —
Rights Copyright (c) 2023 Michele Perks, Denasha L. Reddy, Francois Venter https://creativecommons.org/licenses/by/4.0