ISSN 1301-143X | E-ISSN 1309-1484
Original Article
Comparison of Antiretroviral Therapy Regimens in Terms of Virological Response, Immunological Response and Adverse Effects in Treatment-Naive HIV-Positive Patients
1 Muş Devlet Hastanesi, İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Kliniği, Muş, Türkiye  
2 İstanbul Üniversitesi, İstanbul Tıp Fakültesi, İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, İstanbul, Türkiye  
Klimik Dergisi ; : -
DOI: 10.5152/kd.2018.24
Key Words: HIV, antiretroviral therapy, virological response, immunological response, adverse effects

Objective: In this study, we aimed to determine the demographic and clinical characteristics of HIV-positive patients seen in our faculty; and to put forward the differences in virological response, immunological response and adverse effects of administered antiretroviral therapy (ART) regimens in these patients.

Methods: Medical records of 175 HIV-positive patients over 18 between 2003 and 2015 who have not been treated before, and regularly monitored for six months from the beginning of the therapy were included in the study. Demographic, clinical and laboratory data of patients were collected retrospectively. IBM SPSS Statistics for Windows. Version 21.0 (Statistical Package for the Social Sciences, IBM Corp., Armonk, NY, USA) was used in statistical analysis of the study data.

Results: Mostly used ART regimens in our outpatient clinic were ritonavir-boosted lopinavir (LPV/r) (n=102) and efavirenz (EFV) (n=39) combined with tenofovir/emtricitabine (TDF/FTC). Patients who used LPV/r were in a more advanced disease stage. Acquisition rate of virological response was 59% in the group receiving EFV and 53.9% in the group receiving LPV/r. The average increase in CD4+ T lymphocyte count at the sixth month of therapy was 258±222/μL in LPV/r group, 189±197/ μL in EFV group. The rate of increase in CD4+ T lymphocyte count was in favor of LPV/r group (p=0.017). Skipped drug doses (p=0.211), clinical adverse effects (p=0.276) and modification in ART regimen (p=0.044) were more common in EFV group. Increased cholesterol and low-density lipoprotein (LDL) level and decreased high-density lipoprotein (HDL) level were seen mostly in LPV/r group. Increase in triglyceride level in EFV group and LPV/r group were 30.4% and 68.3%, respectively (p=0.005). Mortality was seen in 5 (2.9%) patients during follow-up.

Conclusions: In terms of obtaining virological response, there was no difference between TDF/FTC+LPV/r group and TDF/FTC+EFV group; whereas LPV/r group had obtained a better immunological response. Modification in ART regimen was done more frequently in patients with EFV, while triglyceride levels were increased more in patients with LPV/r.

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