Table 3.
Unadjusted and adjusted hazard ratios for initial regimen modification for treatment naïve PLWH in the CNICS cohort initiating ART between 2007 – 2015 by cox proportional hazard and categorized by ART drug class
| Characteristic | Univariate analysisa | Multivariable analysisa,b | Multivariable analysisa,b | |||
|---|---|---|---|---|---|---|
| Model 1 | Model 2 | |||||
| Hazard Ratio (95% CI) | P-value | Hazard Ratio (95% CI) | P-value | Hazard Ratio (95% CI) | P-value | |
| Age (yrs) | ||||||
| <30* | 1.0 | 1.0 | 1.0 | |||
| 30–45 | 0.9 (0.8, 1.0) | 0.01 | 0.8 (0.7, 0.9) | <0.001 | 0.8 (0.7, 0.9) | <0.001 |
| >45 | 1.0 (0.9, 1.2) | 0.52 | 0.9 (0.8, 1.0) | 0.12 | 0.9 (0.8, 1.0) | 0.01 |
| Race | ||||||
| White* | 1.0 | 1.0 | 1.0 | |||
| Black | 1.2 (1.1, 1.3) | <0.001 | 1.1 (1.0,1.2) | 0.05 | 1.0 (0.9,1.1) | 0.53 |
| Other | 0.9 (0.8, 1.0) | 0.19 | 0.9 (0.8, 1.0) | 0.19 | 0.9 (0.8, 1.0) | 0.09 |
| Sex | ||||||
| Male* | 1.0 | 1.0 | 1.0 | |||
| Female | 1.5 (1.3, 1.7) | <0.001 | 1.4 (1.2, 1.6) | <0.001 | 1.4 (1.2, 1.6) | <0.001 |
| Insurance | ||||||
| Uninsured* | 1.0 | -- | -- | -- | -- | |
| Private | 0.9 ( 0.8,1.0) | 0.16 | -- | -- | -- | -- |
| Public | 1.2 (1.1, 1.4) | 0.004 | -- | -- | -- | -- |
| Unknown | 1.2 (1.1, 1.3) | 0.002 | -- | -- | -- | -- |
| Transmission Mode | ||||||
| Homosexual* | 1.0 | 1.0 | 1.0 | |||
| Heterosexual | 1.2 (1.1, 1.3) | <0.001 | 1.0 (0.8, 1.1) | 0.59 | 1.0 (0.9, 1.1) | 0.67 |
| IVDU | 1.9 (1.6, 2.2) | <0.001 | 1.6 (1.3, 1.9) | <0.001 | 1.5 (1.3, 1.8) | <0.001 |
| Other | 1.2 (1.1, 1.4) | 0.01 | 1.1 (0.9, 1.3) | 0.32 | 1.1 (0.9, 1.3) | 0.21 |
| CD4 cell count | ||||||
| ≥ 200 | 1.0 | 1.0 | 1.0 | |||
| <200 | 1.3 (1.1, 1.3) | <0.001 | 1.2 (1.1, 1.3) | <0.001 | 1.2 (1.1, 1.3) | <0.01 |
| Unknown | 0.8 (0.4, 1.8) | 0.64 | 0.8 (0.4, 1.9) | 0.65 | 0.9 (0.4, 1.9) | 0.70 |
| Viral Load (copies/m3) | ||||||
| ≥10,000 | 1.0 | 1.0 | 1.0 | |||
| <10,000 | 1.0 (0.9, 1.1) | 0.84 | 1.0 (0.9, 1.1) | 0.68 | 1.0 (0.9, 1.1) | 0.47 |
| Initiation Era | ||||||
| 2007–2009* | 1.0 | 1.0 | 1.0 | |||
| 2010–2012 | 1.2 (1.1, 1.3) | <0.001 | 1.2 (1.1, 1.3) | <0.001 | 1.3 (1.2, 1.6) | <0.001 |
| 2013–2015 | 1.3 (1.1, 1.5) | <0.001 | 1.5 (1.3,1.8) | <0.001 | 2.6 (2.0, 3.0) | <0.001 |
| Class | ||||||
| InSTI * | 1.0 | 1.0 | -- | -- | ||
| InSTI /PI | 2.5 (1.8,3.4) | <0.001 | 2.7 (2.0, 3.7) | <0.001 | -- | -- |
| NNRTI | 0.9 (0.8,1.0) | 0.21 | 1.1 (1.0,1.3) | 0.16 | -- | -- |
| PI | 1.6 (1.4,1.8) | <0.001 | 1.9 (1.6, 2.2) | <0.001 | -- | -- |
| Regimen | -- | -- | ||||
| Dolutegravir/abacavir/lamivudine | 1.4 (0.8, 2.7) | 0.26 | -- | -- | 1.5 (0.8, 2.8) | 0.24 |
| Atazanavir/ritonavir/emtricitabine/tenofovir | 2.6 (2.0, 3.3) | <0.001 | -- | -- | 5.1 (3.8, 6.7) | <0.001 |
| Darunavir/ritonavir/emtricitabine/tenofovir | 2.4 (1.8, 3.1) | <0.001 | -- | -- | 4.0 (3.0, 5.3) | <0.001 |
| Dolutegravir/emtricitabine/tenofovir | 2.7 (1.6, 4.4) | <0.001 | -- | -- | 2.6 (1.6, 4.3) | <0.001 |
| Efavirenz/emtricitabine/tenofovir | 1.6 (1.3, 2.1) | <0.001 | -- | -- | 3.3 (2.5, 4.4) | <0.001 |
| Elvitegravir/cobicistat/emtricitabine/Tenofovir | 1.0 | -- | -- | 1.0 | ||
| Raltegravir/emtricitabine/tenofovir | 2.2 (1.6, 2.9) | <0.001 | -- | -- | 3.9 (2.9, 5.4) | <0.001 |
| Rilpivirine/emtricitabine/tenofovir | 1.2 (0.9, 1.7) | 0.22 | -- | -- | 1.7 (1.2, 2.3) | <0.01 |
| Other | 4.2 (3.3, 5.4) | <0.001 | -- | -- | 8.0 (6.1, 10.7) | <0.001 |
ART=anti-retroviral therapy; CNICS=CFAR Network of Integrated Clinical Systems; InSTI =integrase inhibitor; MSM=men having sex with men; PI=protease inhibitor; NNRTI= a non-nucleoside reverse transcriptase inhibitor; PLWH=people living with HIV/AIDS.
All characteristics (column 1) were obtained prior to ART initiation
Model 1 includes all variables displayed in table except insurance and regimen composition
Model 2 includes all displayed variables except insurance and backbone drug
is reference category
Cox Proportional hazards model
Multivariable model