Sociodemographic and clinical factors associated with the preference between NNRTIs and PIs for the initial treatment of HIV infection: Perfil-es study

ABSTRACT

The Perfil-es study demonstrated that, while non-nucleoside reverse transcriptase inhibitor (NNRTI)-based initial antiretroviral therapy (ART) is more frequently used in human immunodeficiency virus (HIV)-infected naïve patients, ritonavir-boosted protease inhibitors (PI/r)-based regimens are the preferred option in patients with advanced infectious stages or high baseline viral load. The present analysis focused on the second phase of the Perfil-es study, where sociodemographic and clinical data were retrospectively collected from patients starting NNRTI- or PI/r-based regimens in order to identify factors that could influence the choice of initial ART. Patients’ characteristics were compared by both bivariate and multivariate analyses. A total of 642 patients were evaluated. The main transmission group was men who have sex with men (MSM) (48%), and 24% of patients were coinfected with hepatitis B or C. Patients with cardiovascular risk accounted for 56%, and 15% had a neuropsychiatric history. Anxiolytics (29%), antidepressants (18%) and methadone (18%) were the most frequent concomitant medications. The use of PI/r-based regimens was more frequent in older patients, childbearing potential women patients coinfected with hepatitis B or C, and those with cardiovascular risk and a neuropsychiatric history. The presence of a neuropsychiatric disorder (OR: 1.912; CI 95%: 1.146–3.191; p < .05) and the use of concomitant medication (OR: 1.736; CI 95%: 1.204–2.502; p < .01) were identified as independent factors associated with the selection of PI/r-based regimens. MSM sexual conduct was the only independent factor related to the selection of NNRTI-based ART (OR: 0.699; CI 95%: 0.504–0.970; p < .05). Neither the physicians’ characteristics nor the geographical area where HIV patients were attended influenced the choice of ART. In conclusion, patients’ comorbidity, pregnancy potential and lifestyle seem to influence the choice of ART. Neuropsychiatric comorbidity and concomitant medication, mainly related to this condition, appear to be associated with the use of PI/r-based initial ART while MSM seem more likely to receive NNRTI-based regimens in Spain.

KEYWORDS:

• HIV
• naïve
• antiretroviral therapy (ART)
• non-nucleoside reverse transcriptase inhibitors
• protease inhibitors

Acknowledgements

We would like to thank Janssen-Cilag S.A for supporting the study. The authors would also like to acknowledge the investigators and collaborators of the PERFIL-ES Study Group: Aguirrebengoa Ibarguren, K. (Hosp. Cruces); Antela López, A. (Hosp. Santiago); Arazo Garcés, P. (Hosp. Miguel Servet); Asensi, V. (Hosp. Central Asturias); Bassa, A. (Hosp. Son Llatzer, Mallorca); Berenguer Berenguer, J. (Hosp. Gregorio Marañón); Boix Martínez, V. (Hosp. Gral de Alicante); Calvo Sánchez, M. (Hosp. Clínico Barcelona); Canet, R. (Hosp. Can Misses, Ibiza); Cano Sánchez, A. (Hosp. Reina Sofía, Murcia); Cardenes Santana, M. A. (Hosp. Dr. Negrín); Carmena Carmena, J. (Hosp. Dr. Pesset); Cartón, J. A. (Hosp. Central Asturias); Casas García. E. (Hosp. Príncipe de Asturias); Castaño Carracedo, M. A. (Hosp. Carlos Haya); Cervero Jiménez, M. (Hosp. Severo Ochoa); Clotet Sala, B. (Hosp. Universitaria Germans Trias i Pujol, Can Ruti); Condés Moreno, E. (Hosp. Móstoles); Cordero Sánchez, M. (Hosp. Clínico Salamanca); Cortés, M. C. (Hosp. General de L'Hospitalet); Crusells Canales, M. J. (Hosp. Lozano Blesa); Cucurull, J. (Hosp. de Figueres, Centro Penitenciario); Curran, A (Hosp. Vall d'Hebrón); Dalmau, D. (Hosp. Mutua Terrassa); de la Fuente García, B. (Hosp. Cabueñes); Deig, E. (Hosp. Granollers); Domingo Pedrol, P. (Hosp. Sta. Creu i St. Pau); Estrada Pérez, V. (Hosp. Clínico San Carlos); Fariñas Álvarez, M. C. (Hosp. Marqués Valdecilla); Fernández Rodríguez, R. (C.H.O.U); Fernández, P. (Hosp. Can Misses, Ibiza); Ferrero Beneitez, O. L. (Hosp. Basurto); Flores Cid, J. (Hosp. Arnau de Vilanova, Alicante); Galindo Puerto, M. J. (Hosp. Clínico de Valencia); Garcia Deltoro, M. (Hosp. Gral. Valencia); Goenaga Sánchez, M. A. (Hosp. Donosti); Gómez Sirvent, J. L. (Hosp. Clínico Universitario Tenerife); González García. J. (Hosp. La Paz); Gutierrez, F. (Hosp. Gral de Elche); Knobel, H. (Hosp. del Mar, Bcn); Labarga Echevarría, P. (Hosp. Carlos III); Linares, M. (Hosp. Ntra. Sra. de la Candelaria); López Aldeguer, J. L. (Hosp. La Fe, Valencia); López Cortés, L. (Hosp. Virgen del Rocío); López Ruz, M. A. (Hosp. Virgen de las Nieves); Lorenzo González, J. F. (Hosp. Gral. Yagüe); Mallolas, J. (Hosp. Clínico Barcelona); Martín Jiménez, T. (Hosp. Puerta de Hierro); Martín Ruiz, C. (Hosp. Virgen de la Montaña); Merino Muñoz, D. (Hosp. Juan Ramón Jiménez, Huelva); Moreno Torrico, A. (Hops. Central Asturias); Ocampo Hermida, A. (Xeral Cies); Oteo Revuelta, J. A. (Hosp. San Pedro, Logroño); Pardo Reche, P. (Hosp. San Joan de Reus); Pedreira Andrade, J. D. (Hosp. Juan Canalejo); Pedrol Clotet, E. (Hosp. St. Pau i Sta. Tecla); Pérez Elías. M. J. (Hosp. Ramón y Cajal); Pérez Guzmán, E. (Hosp. Puerta del Mar, Cádiz); Pérez-Cecilia, E. (Hosp. Clínico San Carlos); Podzamczer, D. (Hosp. Bellvitge); Portu Zapirain, J. J. (Hosp. Txagorritxu); Pulido Ortega, F. (Hosp. 12 Octubre); Ribera Pascuet, E. (Hosp. Vall d'Hebrón); Riera Jaume, M. (Hosp. Son Dureta, Mallorca); Rivero Román, A. (Hosp. Reina Sofía, Córdoba); Rodríguez, R. (C.H.O.U.); Rubio, R. (Hosp. 12 Octubre); Santos González, J. (Hosp. Clínico de Málaga); Sanz Sanz, J. (Hosp. La Princesa); Tellez Pérez, F. (Hosp. Del SAS de la Línea de la Concepción); Tellez, M. J. (Hosp. Clínico San Carlos); Tornero Estébanez, C. (Hosp. San Francesc de Borja, Gandia); Vera Méndez, F. J. (Hosp. Virgen del Rosell, Cartagena); Vergas, J. (Hosp. Clínico San Carlos); Vicina Fernández, P. (Hosp. Virgen del Rocío).

Disclosure statement

P. Viciana and A. Ocampo declare that they have received honoraria as a consultant from Janssen-Cilag. H. Hevia, M. Palazuelos and F. Ledesma belong to the Medical Department of Janssen-Cilag S.A.

Additional information

Funding

This study was sponsored by Janssen-Cilag S.A.