Laboratory evaluations were graded according to the division of AIDS (DAIDS) toxicity
tables [13]. Creatinine clearance was calculated using the Cockcroft–Gault equation. We recorded any toxicity that led to treatment change, regardless of grade. The proportion of patients achieving HIV-1 RNA<400 copies/mL and the CD4 cell count was measured at 3, 6, 9 and 12 months. Cause of death was determined by chart review. We evaluated adherence using the number this website of missed visits and the proportion of visits with no missed doses, and compared ‘never missed’ doses vs. ‘ever missed’ over the 12-month time period. For resistance analysis, we categorized mutations according to the International AIDS Society USA (IAS-USA) recommendations [14] and categorized patients according to the number of active NRTI drugs based on the baseline genotype pattern. Those with only M184V and NNRTI mutations or wild-type virus were considered to have at least two fully active NRTI drugs or ‘low’ resistance; patients with any thymidine analog mutations (TAMs) or K65R/70E or Q151M were considered to have at least one fully active NRTI drug or ‘medium’ resistance; and patients with the 69 insertion or Q151M complex in combination with K65R or K70E were considered to have no active NRTI drugs or ‘high’ resistance. Additionally, we evaluated responses in patients with wild-type virus, any TAMs, and at least three TAMs.
In all analyses, stata v.10 (STATA Corp., College Station, TX, USA) was used. Student’s t-test and the χ2 or Fisher’s exact test were used to compare continuous and categorical variables, PD0325901 price respectively. We performed logistic RAS p21 protein activator 1 regression analysis to identify factors associated with mortality, mortality and/or morbidity (new WHO stage 3 or 4 clinical event) at 6 and 12 months, and virological suppression to HIV-1 RNA<400 copies at 12 months. For the mortality, and mortality and/or morbidity models,
all confirmed first-line ART virological failures were included; however, for the virological suppression model, only those initiating second-line treatment were included. For all models, factors considered included age, gender, means of failure identification (any clinical vs. immunological only), HIV-1 RNA and CD4 cell count at time of failure identification, duration of first-line ART before presentation, haemoglobin and body mass index (BMI). Additionally, adherence measures (self report of ever having missed a dose/not having missed a dose) and degree of baseline resistance were included as factors in the model related to virological suppression. Categories for continuous variables (age, CD4 cell count, HIV-1 RNA, duration on ART, BMI and haemoglobin) were chosen for clinical significance and to be consistent with the previous literature. For the HIV suppression model, we employed intent-to-treat analysis with deaths and loss to follow-up, but not treatment switches because of toxicity, considered as failures.