AI Article Synopsis
- In the Reflate TB2 trial, researchers studied factors linked to virologic success and adherence in people with HIV and tuberculosis receiving raltegravir or efavirenz treatment.
- Out of 444 participants, 65% achieved virologic success (HIV-1 RNA <50 copies/mL) and maintained adherence (≥95% pill count) over 48 weeks, with several factors influencing these outcomes.
- Key findings indicated that female sex, lower baseline HIV-1 RNA levels, and optimal adherence were associated with virologic success, while a higher antiretroviral pill burden negatively impacted adherence.
Article Abstract
Background: In people with human immunodeficiency virus [HIV] presenting with advanced disease, rates of virologic success may be lower than expected. The Reflate TB2 trial did not show non-inferiority of raltegravir versus efavirenz in people with HIV (PWH) treated for tuberculosis. We aimed to identify factors associated with virologic success and higher adherence in the trial.
Methods: In this analysis, we included participants enrolled in the Reflate TB2 trial with adherence data available. The primary outcome was virologic success (HIV-1 ribonucleic acid [RNA] <50 copies/mL) at week 48, and the secondary outcome was adherence as assessed by the pill count adherence ratio. We used logistic regression to study determinants of virologic success and optimal adherence in 2 separate analyses.
Results: Four hundred forty-four participants were included in the present analysis. Over the 48-week follow-up period, 290 of 444 (65%) participants had a pill count adherence ratio ≥95%. At week 48, 288 of 444 (65%) participants were in virologic success. In the multivariate analysis, female sex (adjusted odds ratio [aOR], 1.77; 95% confidence interval [CI], 1.16-2.72; = .0084), lower baseline HIV-1 RNA levels (<100 000; aOR, 2.29; 95% CI, 1.33-3.96; = .0087), and pill count adherence ratio ≥95% (aOR, 2.38; 95% CI, 1.56-3.62; < .0001) were independently associated with virologic success. Antiretroviral pill burden was the only factor associated with pill count adherence ratio ≥95% (OR, 0.81; 95% CI, .71-.92; = .0018).
Conclusions: In PWH with tuberculosis receiving raltegravir or efavirenz-based regimens, female sex, optimal adherence, and baseline HIV-1 RNA <100 000 copies/mL were associated with virologic success, and the number of antiretroviral tablets taken daily was a strong predictor of adherence.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9757687 | PMC |
| http://dx.doi.org/10.1093/ofid/ofac628 | DOI Listing |
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