Outcome and predictors of failure of highly active antiretroviral therapy:One-year follow-up of a cohort of human immunodeficiency virus type 1 infected persons

The outcome and predictors of virologic treatment failure of highly active antiretroviral therapy (HAART) were determined for 271 human immunodeficien cy virus (HIV)-infected protease inhibitor-naive persons. During a follow-u p of 48 weeks after the:initiation of HAART, 6.3% of patients experienced a t least one new AIDS-defining event, and 3.0% died, Virologic treatment fai lure occurred in 40% (indinavir, 27%; ritonavir, 30%; saquinavir, 59%; rito navir plus saquinavir, 32%; chi(2), P = .001) Risk factors for treatment fa ilure were baseline plasma HIV-1 RNA (odds ratio [OR], 1.70 per log(10) cop ies increase in plasma HIV-1 RNA), baseline CD4 cell count (OR, 1.35 per 10 0 CD4 cells/mm(3) decrease), and use of saquinavir versus other protease in hibitors (OR, 3.21). During the first year of treatment,:53% of all patient s changed (part of) their original HAART regimen at least once. This was si gnificantly more frequent for regimens containing saquinavir (62%; 27% for virologic failure) or ritonavir (64%; 55% for intolerance) as single protea se inhibitor.