Patterns and Predictors of First-Line Antiretroviral Therapy Modification in HIV-1-Infected Adults in a Large Urban Outpatient Cohort in Nigeria

Isaac Okoh Abah; Kristin M. Darin; Augustine Odo Ebonyi; Placcid Ugoagwu; Victor Bazim Ojeh; Naima Nasir; Kakjing D. Falang; Oluremi Olaitan; Oche Agbaji; John Idoko; Phyllis Kanki

doi:10.1177/2325957414565508

Patterns and Predictors of First-Line Antiretroviral Therapy Modification in HIV-1-Infected Adults in a Large Urban Outpatient Cohort in Nigeria

Isaac Okoh Abah^*, Kristin M. Darin, Augustine Odo Ebonyi, Placcid Ugoagwu, Victor Bazim Ojeh, Naima Nasir, Kakjing D. Falang, Oluremi Olaitan, Oche Agbaji, John Idoko, Phyllis Kanki

^*Corresponding author for this work

Medicine, Infectious Diseases Division

Research output: Contribution to journal › Article › peer-review

8 Scopus citations

Abstract

Objective: We described the magnitude, type, and factors associated with first-line antiretroviral therapy (ART) modification in HIV-1-infected adults on ART in Jos, Nigeria. Method: Data on 6309 patients initiated on first-line ART between January 2004 and December 2006 were analyzed retrospectively. Factors predictive of modification to initial ART were assessed by chi-square and multivariable logistic regression analysis. Results: Overall, 5212 (83%) included patients incurred a modification (73.3% drug substitution and 9.7% drug switch) to their initial first-line ARV regimen during a median (interquartile range) follow-up period of 7 (3-8) years. Drug substitutions of zidovudine (ZDV) were less likely than of tenofovir (TDF; adjusted odd ratio [AOR] 0.6; 95% confidence interval [CI]: 0.51-0.71), and Drug substitutions of efavirenz (EFV) were more likely than of nevirapine (NVP)- containing (AOR 1.82; 95% CI: 1.42-2.33) regimens. Predictors of switch to second-line regimen include older age (AOR 2.05; 95% CI: 1.68-2.51), CD4 count ≥100 cells/mm3 (AOR 1.89; 95% CI: 1.49-2.37), EFV compared to NVP (AOR 1.38; 95% CI: 1.02-1.88), and drug toxicity (AOR 1.90; 95% CI: 1.48-2.43). Conclusion: Modification to initial ART was common in this study. Further evaluation of the contribution of guideline changes on regimen modification and treatment outcomes is recommended.

Original language	English (US)
Pages (from-to)	348-354
Number of pages	7
Journal	Journal of the International Association of Providers of AIDS Care
Volume	14
Issue number	4
DOIs	https://doi.org/10.1177/2325957414565508
State	Published - Jul 25 2015

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was funded in part by the US Department of Health and Human Services, Health Resources and Services Administration (U51HA02522), and the Centers for Disease Control and Prevention (CDC) through a cooperative agreement with APIN (PS 001058). We are grateful to the Fogarty International Center, Northwestern University AIDS International Training and Research Program (Grant Numbers R24TW008878 & D43TW007995) for training support and mentorship toward this manuscript. The contents are solely the responsibility of the authors and do not represent the official views of the funding institutions.

Keywords

antiretroviral therapy
regimen durability
substitution
switch

ASJC Scopus subject areas

Infectious Diseases
Dermatology
Immunology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1177/2325957414565508

Cite this

Abah, I. O., Darin, K. M., Ebonyi, A. O., Ugoagwu, P., Ojeh, V. B., Nasir, N., Falang, K. D., Olaitan, O., Agbaji, O., Idoko, J., & Kanki, P. (2015). Patterns and Predictors of First-Line Antiretroviral Therapy Modification in HIV-1-Infected Adults in a Large Urban Outpatient Cohort in Nigeria. Journal of the International Association of Providers of AIDS Care, 14(4), 348-354. https://doi.org/10.1177/2325957414565508

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title = "Patterns and Predictors of First-Line Antiretroviral Therapy Modification in HIV-1-Infected Adults in a Large Urban Outpatient Cohort in Nigeria",

abstract = "Objective: We described the magnitude, type, and factors associated with first-line antiretroviral therapy (ART) modification in HIV-1-infected adults on ART in Jos, Nigeria. Method: Data on 6309 patients initiated on first-line ART between January 2004 and December 2006 were analyzed retrospectively. Factors predictive of modification to initial ART were assessed by chi-square and multivariable logistic regression analysis. Results: Overall, 5212 (83%) included patients incurred a modification (73.3% drug substitution and 9.7% drug switch) to their initial first-line ARV regimen during a median (interquartile range) follow-up period of 7 (3-8) years. Drug substitutions of zidovudine (ZDV) were less likely than of tenofovir (TDF; adjusted odd ratio [AOR] 0.6; 95% confidence interval [CI]: 0.51-0.71), and Drug substitutions of efavirenz (EFV) were more likely than of nevirapine (NVP)- containing (AOR 1.82; 95% CI: 1.42-2.33) regimens. Predictors of switch to second-line regimen include older age (AOR 2.05; 95% CI: 1.68-2.51), CD4 count ≥100 cells/mm3 (AOR 1.89; 95% CI: 1.49-2.37), EFV compared to NVP (AOR 1.38; 95% CI: 1.02-1.88), and drug toxicity (AOR 1.90; 95% CI: 1.48-2.43). Conclusion: Modification to initial ART was common in this study. Further evaluation of the contribution of guideline changes on regimen modification and treatment outcomes is recommended.",

keywords = "antiretroviral therapy, regimen durability, substitution, switch",

author = "Abah, {Isaac Okoh} and Darin, {Kristin M.} and Ebonyi, {Augustine Odo} and Placcid Ugoagwu and Ojeh, {Victor Bazim} and Naima Nasir and Falang, {Kakjing D.} and Oluremi Olaitan and Oche Agbaji and John Idoko and Phyllis Kanki",

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doi = "10.1177/2325957414565508",

language = "English (US)",

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Abah, IO, Darin, KM, Ebonyi, AO, Ugoagwu, P, Ojeh, VB, Nasir, N, Falang, KD, Olaitan, O, Agbaji, O, Idoko, J & Kanki, P 2015, 'Patterns and Predictors of First-Line Antiretroviral Therapy Modification in HIV-1-Infected Adults in a Large Urban Outpatient Cohort in Nigeria', Journal of the International Association of Providers of AIDS Care, vol. 14, no. 4, pp. 348-354. https://doi.org/10.1177/2325957414565508

Patterns and Predictors of First-Line Antiretroviral Therapy Modification in HIV-1-Infected Adults in a Large Urban Outpatient Cohort in Nigeria. / Abah, Isaac Okoh; Darin, Kristin M.; Ebonyi, Augustine Odo et al.
In: Journal of the International Association of Providers of AIDS Care, Vol. 14, No. 4, 25.07.2015, p. 348-354.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Patterns and Predictors of First-Line Antiretroviral Therapy Modification in HIV-1-Infected Adults in a Large Urban Outpatient Cohort in Nigeria

AU - Abah, Isaac Okoh

AU - Darin, Kristin M.

AU - Ebonyi, Augustine Odo

AU - Ugoagwu, Placcid

AU - Ojeh, Victor Bazim

AU - Nasir, Naima

AU - Falang, Kakjing D.

AU - Olaitan, Oluremi

AU - Agbaji, Oche

AU - Idoko, John

AU - Kanki, Phyllis

PY - 2015/7/25

Y1 - 2015/7/25

N2 - Objective: We described the magnitude, type, and factors associated with first-line antiretroviral therapy (ART) modification in HIV-1-infected adults on ART in Jos, Nigeria. Method: Data on 6309 patients initiated on first-line ART between January 2004 and December 2006 were analyzed retrospectively. Factors predictive of modification to initial ART were assessed by chi-square and multivariable logistic regression analysis. Results: Overall, 5212 (83%) included patients incurred a modification (73.3% drug substitution and 9.7% drug switch) to their initial first-line ARV regimen during a median (interquartile range) follow-up period of 7 (3-8) years. Drug substitutions of zidovudine (ZDV) were less likely than of tenofovir (TDF; adjusted odd ratio [AOR] 0.6; 95% confidence interval [CI]: 0.51-0.71), and Drug substitutions of efavirenz (EFV) were more likely than of nevirapine (NVP)- containing (AOR 1.82; 95% CI: 1.42-2.33) regimens. Predictors of switch to second-line regimen include older age (AOR 2.05; 95% CI: 1.68-2.51), CD4 count ≥100 cells/mm3 (AOR 1.89; 95% CI: 1.49-2.37), EFV compared to NVP (AOR 1.38; 95% CI: 1.02-1.88), and drug toxicity (AOR 1.90; 95% CI: 1.48-2.43). Conclusion: Modification to initial ART was common in this study. Further evaluation of the contribution of guideline changes on regimen modification and treatment outcomes is recommended.

AB - Objective: We described the magnitude, type, and factors associated with first-line antiretroviral therapy (ART) modification in HIV-1-infected adults on ART in Jos, Nigeria. Method: Data on 6309 patients initiated on first-line ART between January 2004 and December 2006 were analyzed retrospectively. Factors predictive of modification to initial ART were assessed by chi-square and multivariable logistic regression analysis. Results: Overall, 5212 (83%) included patients incurred a modification (73.3% drug substitution and 9.7% drug switch) to their initial first-line ARV regimen during a median (interquartile range) follow-up period of 7 (3-8) years. Drug substitutions of zidovudine (ZDV) were less likely than of tenofovir (TDF; adjusted odd ratio [AOR] 0.6; 95% confidence interval [CI]: 0.51-0.71), and Drug substitutions of efavirenz (EFV) were more likely than of nevirapine (NVP)- containing (AOR 1.82; 95% CI: 1.42-2.33) regimens. Predictors of switch to second-line regimen include older age (AOR 2.05; 95% CI: 1.68-2.51), CD4 count ≥100 cells/mm3 (AOR 1.89; 95% CI: 1.49-2.37), EFV compared to NVP (AOR 1.38; 95% CI: 1.02-1.88), and drug toxicity (AOR 1.90; 95% CI: 1.48-2.43). Conclusion: Modification to initial ART was common in this study. Further evaluation of the contribution of guideline changes on regimen modification and treatment outcomes is recommended.

KW - antiretroviral therapy

KW - regimen durability

KW - substitution

KW - switch

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Patterns and Predictors of First-Line Antiretroviral Therapy Modification in HIV-1-Infected Adults in a Large Urban Outpatient Cohort in Nigeria

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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