Difficult-to-treat HIV in Sweden : a cross-sectional study
Elvstam, Olof LU
; Dahl, Viktor
; Weibull Wärnberg, Anna
; von Stockenström, Susanne
and Yilmaz, Aylin
(2024)
In BMC Infectious Diseases
24(1).
- Abstract
BACKGROUND: Our aim was to examine the prevalence and characteristics of difficult-to-treat HIV in the current Swedish HIV cohort and to compare treatment outcomes between people with difficult and non-difficult-to-treat HIV.
METHODS: In this cross-sectional analysis of the Swedish HIV cohort, we identified all people with HIV currently in active care in 2023 from the national register InfCareHIV. We defined five categories of difficult-to-treat HIV: 1) advanced resistance, 2) four-drug regimen, 3) salvage therapy, 4) virologic failure within the past 12 months, and 5) ≥ 2 regimen switches following virologic failure since 2008. People classified as having difficult-to-treat HIV were compared with non-difficult for background... (More)
BACKGROUND: Our aim was to examine the prevalence and characteristics of difficult-to-treat HIV in the current Swedish HIV cohort and to compare treatment outcomes between people with difficult and non-difficult-to-treat HIV.
METHODS: In this cross-sectional analysis of the Swedish HIV cohort, we identified all people with HIV currently in active care in 2023 from the national register InfCareHIV. We defined five categories of difficult-to-treat HIV: 1) advanced resistance, 2) four-drug regimen, 3) salvage therapy, 4) virologic failure within the past 12 months, and 5) ≥ 2 regimen switches following virologic failure since 2008. People classified as having difficult-to-treat HIV were compared with non-difficult for background characteristics as well as treatment outcomes (viral suppression and self-reported physical and psychological health).
RESULTS: Nine percent of the Swedish HIV cohort in 2023 (n = 8531) met at least one criterion for difficult-to-treat HIV. Most of them had ≥ 2 regimen switches (6%), and the other categories of difficult-to-treat HIV were rare (1-2% of the entire cohort). Compared with non-difficult, people with difficult-to-treat HIV were older, had an earlier first year of positive HIV test and lower CD4 counts, and were more often female. The viral suppression rate among people with difficult-to-treat HIV was 84% compared with 95% for non-difficult (p = 0.001). People with difficult-to-treat HIV reported worse physical (but not psychological) health, and this remained statistically significant after adjustment for age, sex, and transmission group.
CONCLUSIONS: Although 9% of the HIV cohort in Sweden in 2023 were classified as having difficult-to-treat HIV, a large proportion of these were virally suppressed, and challenges such as advanced resistance and need for salvage therapy are rare in the current Swedish cohort.
(Less)
- author
- Elvstam, Olof
LU
; Dahl, Viktor
; Weibull Wärnberg, Anna
; von Stockenström, Susanne
and Yilmaz, Aylin
- organization
- publishing date
- 2024-03-18
- type
- Contribution to journal
- publication status
- published
- subject
- in
- BMC Infectious Diseases
- volume
- 24
- issue
- 1
- article number
- 325
- publisher
- BioMed Central (BMC)
- external identifiers
-
- scopus:85188110461
- pmid:38500050
- ISSN
- 1471-2334
- DOI
- 10.1186/s12879-024-09214-2
- language
- English
- LU publication?
- yes
- id
- e3bc7681-6ffb-4e37-afff-9789182f01c9
- date added to LUP
- 2024-03-19 12:23:42
- date last changed
- 2024-04-23 07:14:56
@article{e3bc7681-6ffb-4e37-afff-9789182f01c9,
abstract = {{<p>BACKGROUND: Our aim was to examine the prevalence and characteristics of difficult-to-treat HIV in the current Swedish HIV cohort and to compare treatment outcomes between people with difficult and non-difficult-to-treat HIV.</p><p>METHODS: In this cross-sectional analysis of the Swedish HIV cohort, we identified all people with HIV currently in active care in 2023 from the national register InfCareHIV. We defined five categories of difficult-to-treat HIV: 1) advanced resistance, 2) four-drug regimen, 3) salvage therapy, 4) virologic failure within the past 12 months, and 5) ≥ 2 regimen switches following virologic failure since 2008. People classified as having difficult-to-treat HIV were compared with non-difficult for background characteristics as well as treatment outcomes (viral suppression and self-reported physical and psychological health).</p><p>RESULTS: Nine percent of the Swedish HIV cohort in 2023 (n = 8531) met at least one criterion for difficult-to-treat HIV. Most of them had ≥ 2 regimen switches (6%), and the other categories of difficult-to-treat HIV were rare (1-2% of the entire cohort). Compared with non-difficult, people with difficult-to-treat HIV were older, had an earlier first year of positive HIV test and lower CD4 counts, and were more often female. The viral suppression rate among people with difficult-to-treat HIV was 84% compared with 95% for non-difficult (p = 0.001). People with difficult-to-treat HIV reported worse physical (but not psychological) health, and this remained statistically significant after adjustment for age, sex, and transmission group.</p><p>CONCLUSIONS: Although 9% of the HIV cohort in Sweden in 2023 were classified as having difficult-to-treat HIV, a large proportion of these were virally suppressed, and challenges such as advanced resistance and need for salvage therapy are rare in the current Swedish cohort.</p>}},
author = {{Elvstam, Olof and Dahl, Viktor and Weibull Wärnberg, Anna and von Stockenström, Susanne and Yilmaz, Aylin}},
issn = {{1471-2334}},
language = {{eng}},
month = {{03}},
number = {{1}},
publisher = {{BioMed Central (BMC)}},
series = {{BMC Infectious Diseases}},
title = {{Difficult-to-treat HIV in Sweden : a cross-sectional study}},
url = {{http://dx.doi.org/10.1186/s12879-024-09214-2}},
doi = {{10.1186/s12879-024-09214-2}},
volume = {{24}},
year = {{2024}},
}