[Change of antiretroviral therapy in HIV-infected patients].

Introduction: Antiretroviral therapy adherence plays a vital role in treatment onset and in the durability of antiviral response. In addition, clinical status, plasma viral load, and CD4+ cell count are essential in making therapeutic change decisions in various clinical situations. The aim of our study was to assess the reasons for therapy change in both treatment-naive and treatment-experienced patients, and to know the casuistry of antiretroviral therapy change.

Patients And Methods: A retrospective study of 100% of patients who underwent at least one antiretroviral treatment change from January to December 2002. The type of antiretroviral therapy before and after change was analyzed, as were the causes leading to treatment change.

Results: During year 2002, 131 patients (20.15%) had their antiretroviral therapy modified, and the total number of treatment changes in these patients was 151. An analysis of treatment changes revealed that 69 modifications resulted from intolerance/toxicity (45%), 51 from therapeutic failure (34%), 14 from lack of adherence (9%), 10 from therapy simplification (7%), 1 from therapy enhancement (1%), and 6 from other causes (4%).

Conclusions: Adverse events such as (resulting from) intolerance, renal colic, lipodystrophy, pancreatitis, etc., are responsible for a high incidence of therapy changes, mostly in treatment-naive patients. Therapeutic failure and lack of adherence are further causes of medically-relevant therapy modifications.