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Abstract
Antiretroviral Prescriptions In The Two Linked HIV Outpatient Units Of Bologna, Italy
Manfredi R.1, Calza L.1, Chiodo F.1
Introduction: The knowledge of profile and trend of antiretroviral prescriptions (AP) is needed to allocate pharmacologic resources.
Methods: A comparison of electronic databases of AP in the two connected HIV outpatient centres of Bologna (Italy), where ~1900 HIV-infected patients (p) are followed,and 1644 (86.5%) received AP during the year 2003,was performed.
Results: Triple combinations of two nucleoside analogues (NA) and a protease inhibitor (PI) or a non-nucleoside inhibitor (NNRTI), or 3 NA, were given to 68.2% of p,while in 18.2% of p a dual NA association was still used,and the remaining 13.6% of p received >3 drugs.The PI-based AP prevailed over the NNRTI one,and the NA one (38%,31%,and 10%).Among NA,3TC,AZT,d4T,and TDP were prescribed with a significantly greater frequency at the first unit (p<.001 to <.03),while ABC and co-formulated AZT-3TC-ABC were used more frequently at the second unit (p<.02 to p<.05).Among PI, SQVhg and NFV were more common at the first unit (p<.001),and SQVsg at the second unit (p<.04),while NNRTI had a comparable AP.Since AP are performed by the same medical equipe and agreed recommendations,reasons for remarkable differences are expected to be linked to p features:higher prevalence of sexually-transmitted HIV at the first unit,versus greater drug abuse at the second unit (p<.01),and longer AP with more frequent changes at the first versus second unit (p<.004).Among HAART regimens,significant differences are evident according to costs, with d4T-TDP-LPV/r as the most expensive PI-based AP (870 Є/month),versus AZT-3TC-SQVsg/r (547 Є/month).When considering NNRTI-based AP,d4T-TDP-EFZ is more expensive (642 Є/month),versus AZT-3TC-NVP (452 Є/month).
Conclusions: Over nine years after HAART introduction,multiple variables influence the choice of AP,including therapeutic background,resistance,toxicity,adherence,pillburden,and also costs.Even between the two HIV services of the same city,followed by the same medical staff,significant differences in AP occur.Given the availability of 21 drugs,a correct balance of expected long-term efficacy-tolerability should be tailored according to each p needs,but also weighted against scheduled costs,to allow the best resource allocation.
The 3rd IAS Conference on HIV Pathogenesis and Treatment
Abstract no.
MoPe11.2C03
Suggested Citation
"ManfrediR., et al.
Antiretroviral Prescriptions In The Two Linked HIV Outpatient Units Of Bologna, Italy.
Poster Exhibition:
The 3rd IAS Conference on HIV Pathogenesis and Treatment:
Abstract no.
MoPe11.2C03"
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