13th Annual Conference of the British HIV Association 29 March–1 April 2007, Brighton, UK

TRENDS OVER CALENDAR TIME IN THE PREVALENCE OF PATIENTS WITH EXTENSIVE TRIPLE CLASS VIROLOGICAL FAILURE IN THE UK

HIV Med 2007; 8(Suppl. 1):1 (abstract no. O1)
Andrew Phillips, Clifford Leen, Alan Wilson and Caroline Sabin for the UK CHIC Study
Royal Free and University College Medical School, London, UK

AIM/OBJECTIVE: To assess, in a study that combines data from several UK clinics: (i) the prevalence of extensive triple class failure (ETCF) among patients who started ART with ≥3 drugs; and (ii) the proportions of such patients who have viral load <50 copies/mL, and CD4 cell count <200/mm³.

METHODS: Virological failure of a drug was defined by a viral load >500 copies/mL, despite >4 months’ continuous use of that drug. ETCF was defined as virological failure of at least one drug of each of the following nucleoside subclasses: (i) 3TC/FTC; (ii) ZDV/d4T; and (iii) abacavir, ddI and tenofovir, failure of a boosted PI and failure of an NNRTI. We also studied triple class failure (TCF), defined as virological failure of at least one drug in each of the three classes

RESULTS: A total of 10,603 patients who started ART with >3 drugs, 170 (1.6%) have developed ETCF, compared with 499 (4.7%) who developed TCF. In mid-2000, none of the 3156 (0%) patients under follow-up who started ART with >3 drugs had ETCF. Equivalent figures for the years ‘01, ‘02, ‘03, ‘04 and ‘05 were 13/4360 (0.3%), 46/5429 (0.9%), 81/6579 (1.2%), 104/7196 (1.5%) and 120/7176 (1.7%). Of those with ETCF in 2001, the percentage with viral load <50 copies/mL was 15%. For subsequent years it was 20, 37, 40 and 44%. The percentages of those with ETCF with CD4 cell count <200/mm³ in years 2001–2005 were 62, 46, 35, 30 and 26%.

DISCUSSION: The rate of developing ETCF after start of ART is very low (8% by 10 years; CROI 2007). The number of patients under care with ETCF is growing steadily but remains at <2% of all patients who started ART with >3 drugs. An increasing proportion of those with ETCF have viral load <50 copies/mL.

2007-03-29
O1

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