Gender differences in HIV infection: is there a problem? Analysis from the SCOLTA cohorts. in Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie / Biomed Pharmacother. 2014 Apr;68(3):385-90. doi: 10.1016/j.biopha.2014.01.007. Epub 2014 Feb 12.
2014
ASL Città di Torino
Tipo pubblicazione
Journal Article
Autori/Collaboratori (15)Vedi tutti...
Menzaghi B
Unit of Infectious Diseases, Busto Arsizio Hospital, Busto Arsizio, Italy. Electronic address: barbaramenzaghi@libero.it.
Ricci E
Department of Infectious Diseases, L. Sacco Hospital, Milano, Italy.
Vichi F
Unit of Infectious Diseases, Santa Maria Annunziata Hospital, Firenze, Italy.
et alii...
Abstract
OBJECTIVES: Evaluate gender differences with regard to baseline characteristics and outcome of therapy in cohorts of the SCOLTA (surveillance cohort long-term toxicity of antiretrovirals) project. METHODS: The SCOLTA project is an active pharmacovigilance system for new antiretroviral drugs. Since 2002, patients were enrolled in nine cohorts (lopinavir, tenofovir, atazanavir, fosamprenavir, enfuvirtide, tipranavir, darunavir, raltegravir and maraviroc). RESULTS: Two thousand one hundred and fifty-four patients were included in 5 PI cohorts; 607 (28.2%) were female. Women were younger and less frequently HCV-coinfected than men. At study entry, they were less frequently in CDC stage C, but CD4+ cells/mm(3) and detectable HIV-RNA were not different by gender. Women had triglycerides alterations less frequently than men, but showed a higher proportion of low HDL-cholesterol. Women were protected from incident grade 2-4 triglycerides increase (odds ratio=0.39, 95% confidence interval 0.18-0.88; P=0.02). Mean CD4+ cell count increased in both men and women; despite a non-significantly lower initial CD4+ level, women had a better immunological recovery. Women discontinued PI treatment for adverse events and their own will more frequently. CONCLUSIONS: In these cohorts, gender distribution mirrored the Italian HIV population. Women were younger than men when they started their first ARV therapy and when they entered our cohorts. On the same treatment, they had a better immune response, though no significant difference emerged on virologic control and treatment durability. As compared to men, women appeared at lower risk of hypertriglyceridaemia. They stopped PI-based treatment of their own will more frequently than men, suggesting the need for a focused effort on adherence.
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PMID : 24613008
DOI : 10.1016/j.biopha.2014.01.007
Keywords
Anti-HIV Agents/administration & dosage/adverse effects/therapeutic use; Antiretroviral Therapy, Highly Active; CD4 Lymphocyte Count; Cohort Studies; Databases, Factual; Drug-Related Side Effects and Adverse Reactions/epidemiology/etiology/immunology; Female; HIV Infections/drug therapy/epidemiology/immunology/metabolism; Humans; Italy/epidemiology; Logistic Models; Male; Medication Adherence; Pharmacovigilance; Sex Characteristics; Triglycerides/blood; Gender; HIV; Protease inhibitor;