Avaliação de tratamento antiretroviral simplificado em um hospital universitário- Salvador/ Bahia

Abstract

Antiretroviral treatment and adherence to therapy have been the most effective intervention in controlling disease progression, although the human immunodeficiency virus (HIV) remains an important global public health problem. Recent studies have shown that dual therapy improves adherence and clinical outcomes and can potentially decrease toxicity and costs associated with treatment. Objective: To evaluate the virological outcomes of simplified antiretroviral regimens prescribed in a University Hospital in the State of Bahia, Brazil. This is a retrospective cohort conducted at the Magalhães Neto Outpatient Clinic, linked to Professor Edgard Santos University Hospital of the Federal University of Bahia (UFBA). Data were collected from January 2017 to August 2022. We included patients older than 18 years, who had already been submitted to antiretroviral therapeutic regimens in the past, without distinction of sex, and with simplified ART. Data were analyzed using the statistical software JAMOVI, version 2.2.5. Descriptive analyses were performed using frequency tables for categorical variables and median and interquartile range for continuous variables. To analyze the individual association of each qualitative independent variable with the dependent variable, Pearson's chi-square test (significance level of 5%) was used.We analyzed 244 patients of which 65.2% were male, the median age was 58 years (IQR 50-65), evidencing an aging of people living with HIV-PLHIV. Virological suppression corresponded to 98% of the patients, with a median time of 60.50 weeks (IQR 29.25-160.25) and a median of CD4 cells cel/mm3 of 675.00 (IQR 478.50-925.25), moreover, 89.7% of the patients prescribed the DTG+3TC regimen had no history of previous therapeutic failure, while 47.5% of the patients submitted to other therapeutic regimens had already had a history of failure. In addition, 96.7% of the patients did not change simplified regimens, which evidences an effectiveness and therapeutic optimization. The results corroborate the literature, demonstrating a good virological response in simplified regimens during 292 weeks of follow-up, being a safe and effective alternative even in patients with a history of previous therapeutic failure.