gms | German Medical Science

10. Kongress für Infektionskrankheiten und Tropenmedizin (KIT 2010)

Deutsche Gesellschaft für Infektiologie,
Deutsche AIDS-Gesellschaft,
Deutsche Gesellschaft für Tropenmedizin und Internationale Gesundheit,
Paul-Ehrlich-Gesellschaft für Chemotherapie

23.06. - 26.06.2010, Köln

Virological medical quality management – 10 years follow-up

Virologisch Medizinisches Qualitätsmanagement – 10-Jahres-Follow-up

Meeting Abstract

  • H. Knechten - PZB, Aachen, Germany
  • C. Höhn - PZB, Aachen, Germany
  • R. Ehret - PZB, Aachen, Germany
  • F. Wiesmann - PZB, Aachen, Germany
  • P. Braun - PZB, Aachen, Germany
  • NÄAGNO Study Group

10. Kongress für Infektionskrankheiten und Tropenmedizin (KIT 2010). Köln, 23.-26.06.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocP146

DOI: 10.3205/10kit200, URN: urn:nbn:de:0183-10kit2003

Published: June 2, 2010

© 2010 Knechten et al.
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Outline

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Objectives: All antiretroviral treatments and their virological efficacy were analysed in a German Cohort over the past 10 years.

Methods: Between 997 (in 2000) and 2,452 (in 2009) data sets were collected from up to 23 medical-centres in NRW. ART were divided into combinations containing either 3 nucleos(t)ide analogues (NRTI), 2 NRTI + 1 protease-inhibitor (PI), 2 NRTI + 1 non-nucleoside-reverse-transcriptase-inhibitor (NNRTI) and all other combinations as “other” regimens. Therapy success was defined as HIV1-RNA < 40 copies/ml. Additionally, the proportion and efficacy of firstline regimens were evaluated.

Results: The moderately increasing number of patients receiving ART (from 77.1% in 2000 to 81.8% in 2009) was accompanied by a remarkable increase of therapy success from 71.9% to 85.5%, respectively. There were no greater changes in the prescribing patterns concerning the antiretroviral regimens. Preferred combinations in 2009 were 2 NRTI + 1 PI with 43.2% followed by NNRTI combinations (39.1%) and “other” regimens (13.1%) and combinations with 3 NRTIs (2.6%).

Until 2009 therapy success increased as follows: 2 NRTI + 1 PI: 68.7% to 83.4%; 2 NRTI + 1 NNRTI: 72.8% to 90.4% and other regimens: 44.5% to 77.2%. Last year 30.5% of the treated patients received a firstline regimen with a success rate of 84.0%, 1.5% lower than overall success. Firstline regimens parted in: 3 NRTI with 4.3%; 2 NRTI + 1 PI with 42.9%; 2 NRTI + 1 NNRTI with 48.7% and other regimens with 4.4%.

New approved drugs counted as “other” regimens had a proportion of: Integrase-Inhibitors 3.4%, and Fusion-Inhibitors 0.3% and CCR5 antagonists 1.1% and showed a therapy success of 84.1%, 42.9% and 69.6%, respectively.

Conclusions: Over the time all regimens achieved a higher therapy success which can be due to a simplified mode of intake, improved drug formulations, new substance classes or treatment strategies. Moreover, the feedback given to the individual centres can lead to an improvement of quality in HIV-treatment. Lower firstline success is partly caused by recently started therapies not reaching undetectable viral loads yet. Mainly Fusion Inhibitors are used in deep salvage which might be a reason for the lower success of this drug class. With rising prescriptions of the new approved drug classes they will be considered more in detail in future evaluations.