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Updated: Feb 27, 2026

Rapid Screening of HIV Reverse Transcriptase and Integrase Inhibitors
Published on: April 9, 2014
HIV陽性患者におけるメディケア受給者間の抗レトロウイルス療法切り替え
Mary J Christoph1, Uche Mordi1, Suying Li2
1Gilead Sciences, Inc., Foster City, CA.
Background:
Persistence to antiretroviral therapy (ART) is essential for optimal HIV treatment outcomes. People with HIV (PWH) enrolled in Medicare often have a higher prevalence of comorbidities, which can negatively impact persistence, leading to suboptimal HIV outcomes.
Objective:
To compare ART switch patterns among PWH insured by Medicare.
Methods:
Using Medicare Fee-for-Service and Medicare Advantage claims data from January 2017 to December 2022, a retrospective cohort study of treatment-experienced PWH aged 18 years and older and on ART was conducted. ART regimens included bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF), dolutegravir/lamivudine (DTG/3TC), dolutegravir/abacavir/lamivudine (DTG/ABC/3TC), or multitablet regimens (MTRs; dolutegravir + emtricitabine/tenofovir alafenamide [DTG + F/TAF] or dolutegravir + emtricitabine/tenofovir disoproxil fumarate [DTG + F/TDF]). An analysis of PWH who had mental health and/or substance use disorders was also conducted. Treatment switch by ART regimen was evaluated using Kaplan-Meier curves, log-rank tests, and Cox proportional hazards models after using inverse probability treatment weighting to balance across groups.
Results:
A total of 30,205 treatment-experienced PWH were included. PWH who initiated DTG/3TC, DTG/ABC/3TC, and MTRs on the index date had 1.28 (95% CI = 1.13-1.45), 2.67 (95% CI = 2.47-2.89), and 5.37 (95% CI = 4.60-6.26) times higher hazard ratio of switching ART, respectively, compared with PWH indexed on B/F/TAF (all P < 0.0001). Similar results were observed among PWH with mental health and/or substance use disorders.
Conclusions:
Medicare-insured PWH indexed on B/F/TAF had lower risk of treatment switch compared with other ART regimens, both overall and in the subgroup with mental health and/or substance use disorders. These findings may inform targeted strategies for optimal treatment selection for PWH.
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関連する概念動画
Retrovirus Life Cycles
Retroviruses
Sexually Transmitted Infections
Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment
Therapeutic Drug Monitoring: Affecting Factors
Subviral Agents

