Table 2.
Factors associated with virological failure
| Cases, N = 76 | Controls, N = 184 | ORs of viral rebound >200 RNA copies/mL plasma |
||||
|---|---|---|---|---|---|---|
| unadjusted OR (95% CI) | P | adjusteda OR (95% CI) | P | |||
| Gender, n (%) | ||||||
| male | 54 (71.1) | 153 (83.2) | 1.00 | 1.00 | ||
| female | 22 (28.9) | 31 (16.8) | 2.01 (1.07–3.77) | 0.029 | 1.61 (0.73–3.53) | 0.239 |
| Ethnicity, n (%) | ||||||
| non-black | 69 (90.8) | 182 (98.9) | 1.00 | 1.00 | ||
| black | 7 (9.2) | 2 (1.1) | 9.23 (1.87–45.53) | 0.006 | 13.62 (2.25–82.49) | 0.004 |
| HIV-1 subtype, n (%) | ||||||
| B | 52 (68.4) | 139 (75.5) | 1.00 | 1.00 | ||
| non-B | 24 (31.6) | 45 (24.5) | 1.43 (0.79–2.57) | 0.238 | 1.28 (0.64–2.59) | 0.484 |
| Calendar year of starting ART, median (IQR) | ||||||
| per more recent | 2003 (2001–05) | 2004 (2002–06) | 0.88 (0.79–0.97) | 0.010 | 0.85 (0.72–1.01) | 0.072 |
| Time from sample to ART initiation, median (IQR) | ||||||
| per month longer | 2.97 (1.21–5.02) | 1.61 (0.00–3.31) | 1.04 (1.00–1.08) | 0.038 | 1.07 (1.02–1.12) | 0.006 |
| HIV-1 RNA at NNRTI initiation, median (IQR) | ||||||
| per log10 copies/mL higher | 4.85 (4.54–5.30) | 4.91 (4.50–5.36) | 0.94 (0.58–1.54) | 0.817 | 1.26 (0.68–2.33) | 0.466 |
| NNRTI started, n (%) | ||||||
| nevirapine | 21 (27.6) | 21 (11.4) | 1.00 | 1.00 | ||
| efavirenz | 55 (72.4) | 163 (88.6) | 0.34 (0.17–0.66) | 0.002 | 0.43 (0.18–1.02) | 0.055 |
| NRTI backbone started, n (%) | ||||||
| recommended: ABC/3TC or TDF/FTC | 17 (22.4) | 64 (34.8) | 1.00 | 1.00 | ||
| alternative: ZDV/3TC or TDF/3TC | 36 (47.4) | 96 (52.2) | 1.41 (0.73–2.73) | 0.304 | 0.84 (0.30–2.32) | 0.732 |
| not recommended | 23 (30.3) | 24 (13.0) | 3.61 (1.65–7.89) | 0.001 | 2.39 (0.74–7.69) | 0.145 |
| Detection of ≥1 IAS-USA MV prior to ART, any RTI, n (%) | ||||||
| no | 52 (68.4) | 153 (83.2) | 1.00 | 1.00 | ||
| yes | 24 (31.6) | 31 (16.8) | 2.28 (1.23–4.23) | 0.009 | 2.75 (1.35–5.60) | 0.005 |
| Detection of ≥1 IAS-USA NRTI MV prior to ART, n (%) | ||||||
| no | 68 (89.5) | 175 (95.1) | 1.00 | 1.00 | ||
| yes | 8 (10.5) | 9 (4.9) | 2.29 (0.85–6.17) | 0.102 | 2.27 (0.76–6.77) | 0.140 |
| Detection of ≥1 IAS-USA NNRTI MV prior to ART, n (%) | ||||||
| no | 57 (75.0) | 158 (85.9) | 1.00 | 1.00 | ||
| yes | 19 (25.0) | 26 (14.1) | 2.03 (1.04–3.94) | 0.037 | 2.41 (1.12–5.18) | 0.024 |
| Mutational load (RNA copies/mL), n (%) | ||||||
| 0 | 52 (68.4) | 153 (83.2) | 1.00 | 1.00 | ||
| 400–1000 | 6 (7.9) | 8 (4.3) | 2.21 (0.73–6.66) | 0.160 | 2.58 (0.68–9.73) | 0.162 |
| >1000 | 18 (23.7) | 23 (12.5) | 2.30 (1.15–4.60) | 0.018 | 2.81 (1.26–6.24) | 0.011 |
IAS-USA, IAS-USA HIV-1 drug resistance mutation list (March 2013 update); ABC, abacavir; TDF, tenofovir disoproxil fumarate; 3TC, lamivudine; FTC, emtricitabine; ZDV, zidovudine.
aAdjusted for calendar year of starting first-line ART, time from sample to ART initiation, viral load at ART initiation, NRTI pair started, NNRTI started, ethnicity, HIV-1 subtype, gender and cohort study.