Effect of the change in antirretroviral therapy on virological failure in a cohort of patients living with HIV in Medellín, Antioquia, Colombia.

Efecto del cambio de la terapia antirretroviral en la falla virológica en una cohorte de pacientes que conviven con el VIH en Medellín, Antioquia, Colombia Effect of the change in antirretroviral therapy on virological failure in a cohort of patients living with HIV in Medellín, Antioquia, Colombia.

Published 2020-04-24


https://doi.org/10.30554/archmed.20.2.3490.
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Gómez Hernández, A. J. ., Medina Vásquez, L. M., Molina Castaño, C. F. ., & Botero Garcés, J. H. . (2020). Effect of the change in antirretroviral therapy on virological failure in a cohort of patients living with HIV in Medellín, Antioquia, Colombia.: Effect of the change in antirretroviral therapy on virological failure in a cohort of patients living with HIV in Medellín, Antioquia, Colombia. Archivos De Medicina , 20(2), 269-281. https://doi.org/10.30554/archmed.20.2.3490.
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https://doi.org/10.30554/archmed.20.2.3490.
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Gómez Hernández, A. J. ., Medina Vásquez, L. M., Molina Castaño, C. F. ., & Botero Garcés, J. H. . (2020). Effect of the change in antirretroviral therapy on virological failure in a cohort of patients living with HIV in Medellín, Antioquia, Colombia.: Effect of the change in antirretroviral therapy on virological failure in a cohort of patients living with HIV in Medellín, Antioquia, Colombia. Archivos De Medicina , 20(2), 269-281. https://doi.org/10.30554/archmed.20.2.3490.

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Andrea Juliana Gómez Hernández
Universidad de Ciencias de la Salud
https://orcid.org/0000-0002-9717-9072 ORCID
Lina María Medina Vásquez
Universidad de Ciencias de la Salud – CES
https://orcid.org/0000-0002-6495-7819 ORCID
Carlos Federico Molina Castaño
Universidad de Ciencias de la Salud – CES
https://orcid.org/0000-0002-1339-012X ORCID
Jorge Humberto Botero Garcés
Corporación para Investigaciones Biológicas-CIB
https://orcid.org/0000-0002-3478-0194 ORCID
Juan Carlos Alzate Angel
Corporación para Investigaciones Biológicas-CIB.
https://orcid.org/0000-0003-0319-0623 ORCID
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Andrea Juliana Gómez Hernández,

Médica General, Especialista en Epidemiologia, Facultad de Medicina, Universidad de Ciencias de la Salud – CES. Medellín, Colombia. 

Lina María Medina Vásquez,

Médica General, Especialista en Epidemiologia, Facultad de Medicina, Universidad de Ciencias de la Salud – CES. Medellín, Colombia.

Carlos Federico Molina Castaño,

Médico y Cirujano, Especialista en Toxicología Clínica, Especialista en Salud Ocupacional y Doctor en Epidemio-logía. Facultad de Medicina, Universidad de Ciencias de la Salud – CES y Tecnológico de Antioquia. Medellín, Colombia. 

Jorge Humberto Botero Garcés,

Médico y Cirujano, MSc en Inmunología, Especialista en estadística. Grupo de Parasitología, Facultad de Medici-na, Universidad de Antioquia, Unidad de Investigación Clínica, Corporación para Investigaciones Biológicas-CIB. Medellín, Colombia. 

Juan Carlos Alzate Angel,

Médico, MSc en Epidemiología Clínica. Unidad de Investigación Clínica, Corporación para Investigaciones Biológicas-CIB. Medellín, Colombia. 

Objective: to determine the effect of the change in antiretroviral therapy on virological control in a cohort of HIV positive patients corresponding to a healthcare institution in Medellín, Antioquia (Colombia) in 2017. Materials and methods: cross-sectional, comparative analytical observational study. It was performed in a cohort of 1245 patients living with HIV. Results: a total of 322 patients were evaluated. The main reason for change was the presence of adverse effects to antiretroviral therapy, followed by virological failure without genotype and antiretroviral therapy intolerance. Virological failure, PR 1.4 95% CI (1.2-1.6, p 0,00), having genotype, PR 1.2 95% CI (1.1-1.3, p 0,00 ) and suffering from an opportunistic infection, PR 1.3 95% CI (1.0-1.6, p 0,03), were associated with a greater number of changes to antiretroviral therapy. Adherence to antiretroviral therapy, PR 0.18 95% CI (0.1-0.3, p 0,00) and taking other non-HIV-related medications (PR 0.6, 95% CI 0.4-0 , 8, p 0,005) were associated with a lower frequency of change of antiretroviral therapy. The change in antiretroviral therapy (adjusted OR 3.4, 95% CI (2.0-5.8)) remains the most important prognostic factor for virological failure. Conclusion: the change in antirretroviral therapy, defined in this study as the main exposure variable, represents the main risk factor for virological failure, even when was adjusted for other variables.

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