Impact of Drug Resistance on Death Risk in HIV Patients Starting HAART
Author Information
Author(s): Robert S. Hogg, David R. Bangsberg, Viviane D. Lima, Chris Alexander, Simon Bonner, Benita Yip, Evan Wood, Winnie W. Y. Dong, Julio S. G. Montaner, P. Richard Harrigan
Primary Institution: British Columbia Centre for Excellence in HIV/AIDS
Hypothesis
What is the impact of the emergence of drug-resistance mutations on survival among persons initiating HAART?
Conclusion
Emergence of resistance to non-nucleoside reverse transcriptase inhibitors is associated with a greater risk of death compared to other drug classes.
Supporting Evidence
- A total of 207 deaths were identified among 1,138 participants over the follow-up period.
- Emergence of any resistance was associated with a hazard ratio of 1.75 for mortality.
- Patients with resistance to non-nucleoside reverse transcriptase inhibitors had a mortality rate 3.02 times higher.
Takeaway
If people starting HIV treatment develop resistance to certain drugs, they are more likely to die. This is especially true for those resistant to non-nucleoside reverse transcriptase inhibitors.
Methodology
The study followed 1,138 antiretroviral-naïve patients starting HAART, analyzing mortality rates and drug resistance using Cox proportional hazard regression models.
Potential Biases
Potential bias due to assumptions made about patients with undetectable viral loads.
Limitations
The study may not account for unmeasured differences between patients who died and those who did not.
Participant Demographics
The median age was 37 years, with 84% male participants and 27.9% having a history of injection drug use.
Statistical Information
P-Value
p<0.05
Confidence Interval
1.27, 2.43
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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