Factors associated with the selection of initial antiretroviral therapy from 2009 to 2012

Abstract

We examined factors associated with selection of initial antiretroviral regimen in the CNICS cohort. Patients initiating antiretroviral therapy (ART) between July 2009 and Dec 2012 were classified as receiving an NNRTI, boosted-PI, or raltegravir-based regimen. Among 873 patients initiating ART, 488 regimens contained an NNRTI, 319 a boosted-PI, and 66 raltegravir. Patients with depression and women were less likely to receive an NNRTI, while those with underlying cardiovascular disease, liver disease, and those co-infected with hepatitis C were more likely to receive raltegravir. Those with baseline viral load > 100,000 c/ml and those with substance use were more likely to receive a boosted PI. Thus, in the ‘real world’ ARV regimen choices appear to take into account adverse effects and patient baseline characteristics. Factors that impact initial regimen selection will likely become more heterogeneous over time as more choices for HIV therapy become available.