Skip to main content

Patient characteristics and treatment outcomes associated with protease inhibitor (PI) use in the Asia-Pacific region

Purpose of the study

PI-based regimens are rarely used in developing countries due to the high cost and low availability. We evaluated characteristics of patients initiating PI-based therapy according to previous antiretroviral (ARV) exposure; factors associated with initiating a PI therapy using newer vs. older PIs; and detectable viral load (VL) following the initiation of a PI-based regimen.

Methods

This analysis includes all patients initiating a PI-based regimen. ARV exposure was categorised according to the initiation of PI-based therapy: naïve (no previous ARV), 1st, 2nd, >3rd switches; a switch was defined as starting or stopping any drug in a regimen. Newer PIs were defined as those that were approved by the US FDA after January 1, 2000. Detectable VL at 12 months was defined as VL > 400 copies/mL. Characteristics at PI initiation were evaluated. Logistic regression was used to determine factors associated with initiating a newer PI and detectable VL at 12 months after a PI initiation.

Summary of results

1,106 patients initiated PI-based therapy, [618 (56%) were naïve to PI-based therapy] and the main reason for a change to PI was treatment failure (26%). Following PI initiation, 793 (72%) had VL measurements at 12 months. For multiple logistic regression analysis, switch patients were less likely to use a newer PI [1st, odds ratio (OR) = 0.22, p < 0.001; 2nd, OR = 0.12, p < 0.001; and >3rd switches, OR = 0.14, p < 0.001; vs. naïve]. Being from a high income country (vs. mid/low income OR = 1.67, p = 0.005), patent PI (vs. generic PI, OR = 18.64, p < 0.001), and years from HIV diagnosis to PI initiation (OR = 1.07 per year, p = 0.017) were associated with more use of a newer PI. Overall, 22% (176) of patients had detectable VL at 12 months following the PI initiation. Among naïve patients, the only predictor for detectable VL was baseline CD4 [CD4 200–350 cells/μL, OR = 0.28, p = 0.001; CD4 > 350 cells/μL, OR = 0.73, p = 0.445; vs. CD4 <200 cells/μL]. In experienced patients, higher baseline CD4 [CD4 200–350 cells/μL, OR = 0.39, p = 0.024; CD4 > 350 cells/μL OR = 0.69, p = 0.469; vs. CD4<200 cells/μL] was less likely to have a detectable VL. Being from a high income country (vs. mid/low income, OR = 1.80, p = 0.034) was more likely to associate with detectable VL.

Conclusion

Newer PI-based regimens were prescribed more in high income countries than in other countries in Asia. Short-term virological outcomes following PI therapy in our cohort were good, and were related with CD4 count at time of initiation.

Author information

Authors and Affiliations

Authors

Rights and permissions

Open Access This is an open access article distributed under the terms of the Creative Commons Attribution Noncommercial License ( https://creativecommons.org/licenses/by-nc/2.0 ), which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

Reprints and Permissions

About this article

Cite this article

Pujari, S., Sungkanuparph, S., Srasuebkul, P. et al. Patient characteristics and treatment outcomes associated with protease inhibitor (PI) use in the Asia-Pacific region. JIAS 11, P72 (2008). https://doi.org/10.1186/1758-2652-11-S1-P72

Download citation

  • Published:

  • DOI: https://doi.org/10.1186/1758-2652-11-S1-P72

Keywords

  • Protease Inhibitor
  • Viral Load
  • High Income Country
  • Multiple Logistic Regression Analysis
  • Detectable Viral Load