Age, adherence and injection drug use predict virological suppression among men and women enrolled in a population-based antiretroviral drug treatment programme

• Published in: Antiviral therapy Vol. 8; no. 6; pp. 569 - 575
• Main Authors: O'CONNELL, Jacqueline M, BRAITSTEIN, Paula, HOGG, Robert S, YIP, Benita, CRAIBL, Kevin J. P, O'SHAUGHNESSY, Michael V, MONTANER, Julio S. G, BURDGE, David R
• Format: Journal Article
• Language: English
• Published: London International Medical Press 01.12.2003
• Subjects: Adult; Age Factors; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiviral agents; Biological and medical sciences; Female; HIV Infections - drug therapy; HIV Infections - virology; Humans; Logistic Models; Male; Medical sciences; Patient Compliance; Pharmacology. Drug treatments; Retrospective Studies; RNA, Viral - blood; Sex Factors; Substance Abuse, Intravenous - complications; Human; Immunopathology; Drug addiction; Drug combination; Prognosis; Treatment efficiency; Male; AIDS; Immune deficiency; Epidemiology; Infection; Drug compliance; Chemotherapy; Treatment; Viral disease; Antiviral; Female; Predictive factor; Age
• ISSN: 1359-6535; 2040-2058
• DOI: 10.1177/135965350300800601

To characterize 1-year virological response to antiretroviral therapy and its determinants by sex. This is a population-based analysis of antiretroviral therapy naive HIV-positive adult men and women. Factors associated with sex and with plasma HIV RNA viral load suppression to below 500 copies/ml were examined using non-parametric tests and logistic regression analyses. A total of 739 subjects (92 women and 647 men) were eligible. Female participants were younger (34 vs 37 years; P < 0.001), less likely to have AIDS (6.5 vs 14.4%; P = 0.039), more frequently injection drug users (44.6 vs 25.2%; P = 0.001) and were less likely to be adherent to therapy (34.8 vs 62.9%; P < 0.001) than male participants. There was no difference in baseline median CD4 count (P = 0.424) or HIV RNA levels (P = 0.140), physician experience (P = 0.057), or with respect to antiretroviral regimens containing protease inhibitors or non-nucleoside reverse transcriptase inhibitors (P = 0.911). With treatment, 46.7% (43/92) of women and 64.8% (419/647) of men (P = 0.001) suppressed HIV RNA viral load to below 500 copies/ml at 1 year. In a multivariate analysis, the association of sex with HIV RNA response to antiretroviral therapy fell from statistical significance (odds ratio 1.18; 95% CI: 0.72-1.95) after adjusting for adherence, injection drug use and age. Our data indicate that in this population-based setting, sex differences in 1-year virological response to antiretroviral therapy are explained by age, adherence and injection drug use.