Table 2.
Risk factors associated with first-line ART regimen durability, or time to second-line ART regimen, from first-line ART regimen initiation
| Number of treatment discontinuations | pys | Rate per 100 pys | 95% CI | Univariate | Multivariate | |||||
|---|---|---|---|---|---|---|---|---|---|---|
|
| ||||||||||
| HR | 95% CI | P-value | HR | 95% CI | P-value | |||||
| Total | 4,336 | 38,798.7 | 11.2 | 10.8, 11.5 | ||||||
|
| ||||||||||
| Year of ART Initiation | 0.057 | 0.635 | ||||||||
| 2003–2005 | 1,113 | 9,150.8 | 12.2 | 11.5, 12.9 | 1.00 | 1.00 | ||||
| 2006–2009 | 1,929 | 18,327.2 | 10.5 | 10.1, 11 | 0.94 | 0.87, 1.02 | 0.149 | 1.00 | 0.92, 1.08 | 0.983 |
| 2010–2013 | 1,294 | 11,320.6 | 11.4 | 10.8, 12.1 | 0.91 | 0.83, 1.00 | 0.056 | 1.02 | 0.93, 1.13 | 0.631 |
|
| ||||||||||
| Age at ART initiation | 0.096 | 0.285 | ||||||||
| ≤30 years | 1,003 | 10,131.5 | 9.9 | 9.3, 10.5 | 1.00 | 1.00 | ||||
| 31–40 years | 2,001 | 17,541.6 | 11.4 | 10.9, 11.9 | 1.10 | 1.02, 1.19 | 0.015 | 1.08 | 1.00, 1.17 | 0.042 |
| 41–50 years | 885 | 7,461.2 | 11.9 | 11.1, 12.7 | 1.11 | 1.01, 1.21 | 0.031 | 1.08 | 0.98, 1.18 | 0.116 |
| 51+ years | 447 | 3,664.4 | 12.2 | 11.1, 13.4 | 1.07 | 0.96, 1.20 | 0.228 | 1.05 | 0.93, 1.18 | 0.420 |
|
| ||||||||||
| Sex | ||||||||||
| Male/transgender | 3,160 | 26,057.0 | 12.1 | 11.7, 12.6 | 1.00 | 1.00 | ||||
| Female | 1,176 | 12,741.6 | 9.2 | 8.7, 9.8 | 0.88 | 0.82, 0.94 | <0.001 | 0.90 | 0.84, 0.97 | 0.007 |
|
| ||||||||||
| Mode of HIV Exposure | 0.817 | 0.614 | ||||||||
| Heterosexual contact | 3,445 | 31,286.9 | 11.0 | 10.6, 11.4 | 1.00 | 1.00 | ||||
| Homosexual contact | 407 | 3,023.6 | 13.5 | 12.2, 14.8 | 0.96 | 0.85, 1.09 | 0.550 | 1.03 | 0.91, 1.17 | 0.648 |
| Injecting drug use | 132 | 1,664.2 | 7.9 | 6.7, 9.4 | 1.00 | 0.82, 1.21 | 0.964 | 0.92 | 0.74, 1.14 | 0.422 |
| Other/unknown | 352 | 2,824.0 | 12.5 | 11.2, 13.8 | 0.95 | 0.84, 1.07 | 0.373 | 0.95 | 0.84, 1.07 | 0.404 |
|
| ||||||||||
| HIV viral load at ART initiation | 0.012 | 0.020 | ||||||||
| ≤999 copies/ml | 27 | 287.8 | 9.4 | 6.4, 13.7 | 1.00 | 1.00 | ||||
| 1 000–10 000 copies/ml | 71 | 664.3 | 10.7 | 8.5, 13.5 | 1.01 | 0.65, 1.58 | 0.951 | 1.11 | 0.71, 1.74 | 0.633 |
| ≥10 001 copies/ml | 841 | 6,799.3 | 12.4 | 11.6, 13.2 | 1.36 | 0.92, 1.99 | 0.119 | 1.37 | 0.93, 2.01 | 0.110 |
| Not tested | 3,397 | 31,047.4 | 10.9 | 10.6, 11.3 | 1.58 | 1.08, 2.32 | 0.018 | 1.49 | 1.01, 2.18 | 0.043 |
|
| ||||||||||
| CD4+ T-cell count at ART initiation | <0.001 | <0.001 | ||||||||
| ≤50 cells/μl | 937 | 8,525.0 | 11.0 | 10.3, 11.7 | 1.00 | 1.00 | ||||
| 51–100 cells/μl | 605 | 5,342.0 | 11.3 | 10.5, 12.3 | 0.89 | 0.80, 0.98 | 0.023 | 0.89 | 0.80, 0.99 | 0.028 |
| 101–200 cells/μl | 990 | 9,641.2 | 10.3 | 9.6, 10.9 | 0.78 | 0.71, 0.86 | <0.001 | 0.79 | 0.72, 0.87 | <0.001 |
| 201+ cells/μl | 970 | 9,811.7 | 9.9 | 9.3, 10.5 | 0.71 | 0.65, 0.78 | <0.001 | 0.72 | 0.65, 0.79 | <0.001 |
| Not tested | 834 | 5,478.7 | 15.2 | 14.2, 16.3 | 1.11 | 1.01, 1.23 | 0.035 | 1.12 | 1.02, 1.24 | 0.024 |
|
| ||||||||||
| First-line ART regimen | <0.001 | <0.001 | ||||||||
| NRTI+NNRTI | 3,943 | 36,882.5 | 10.7 | 10.4, 11.0 | 1.00 | 1.00 | ||||
| NRTI+PI | 349 | 1,773.6 | 19.7 | 17.7, 21.9 | 1.52 | 1.33, 1.73 | <0.001 | 1.45 | 1.27, 1.65 | <0.001 |
| Other | 44 | 142.6 | 30.9 | 23.0, 41.5 | 2.14 | 1.58, 2.91 | <0.001 | 2.06 | 1.52, 2.81 | <0.001 |
|
| ||||||||||
| Previous mono/duo exposure | ||||||||||
| No | 4,061 | 37,413.3 | 10.9 | 10.5, 11.2 | 1.00 | 1.00 | ||||
| Yes | 275 | 1,385.4 | 19.9 | 17.6, 22.3 | 1.79 | 1.58, 2.02 | <0.001 | 1.76 | 1.55, 2.00 | <0.001 |
|
| ||||||||||
| Hepatitis B (surface antigen) co-infection | 0.146 | 0.012 | ||||||||
| Negative | 2,192 | 21,576.7 | 10.2 | 9.7, 10.6 | 1.00 | 1.00 | ||||
| Positive | 227 | 2,265.6 | 10.0 | 8.8, 11.4 | 1.11 | 0.96, 1.27 | 0.148 | 1.07 | 0.93, 1.23 | 0.332 |
| Not tested | 1,917 | 14,956.3 | 12.8 | 12.3, 13.4 | 0.95 | 0.88, 1.03 | 0.260 | 0.85 | 0.76, 0.96 | 0.007 |
|
| ||||||||||
| Hepatitis C (antibody) co-infection | 0.551 | 0.703 | ||||||||
| Negative | 1,924 | 19,521.9 | 9.9 | 9.4, 10.3 | 1.00 | 1.00 | ||||
| Positive | 187 | 2,170.4 | 8.6 | 7.5, 9.9 | 1.05 | 0.89, 1.23 | 0.584 | 1.03 | 0.85, 1.23 | 0.785 |
| Not tested | 2,225 | 17,106.4 | 13.0 | 12.5, 13.6 | 0.96 | 0.87, 1.05 | 0.379 | 1.06 | 0.93, 1.20 | 0.416 |
Bold represents P-values <0.05. Global P-values for year of antiretroviral therapy (ART) initiation, age and pre-ART CD4+ T-cell count are test for trend. Other global P-values are test for heterogeneity. HR, hazard ratio; NNRTI, non-nucleoside reverse transcriptase inhibitor; NRTI, nucleoside reverse transcriptase inhibitor; PI, protease inhibitor; pys, person-years.