Profiles and persistence of initial antiretroviral therapy among HIV infected patients in taiwan: A nationwide population-based cross-sectional study from 2011 to 2017.

Abstract

Antiretroviral therapy (ART) has been applied for treating patients with human immunodeficiency virus (HIV) for decades. Our study explored initial ART use patterns and ART persistence in patients who begin HIV treatment in Taiwan. The National Health Insurance Research Database in Taiwan was used in our study. The study cohort included patients who are incident ART users from 2011 to 2017. The patterns of ART-based regimens initiated were documented, mainly including non-nucleoside reverse transcriptase inhibitor (NNRTI)-based, protease inhibitor (PI)-based and integrase inhibitor (INI)-based regimens. Time from HIV diagnosis to ART initiation, ART persistence, and ART treatment patterns were documented. There were 19,726 incident ART users. While NNRTI-based regimen was the first choice of initial ART from 2011 to 2017, INI-based regimen accounted for 52.9% of total ART initiation and was the most commonly prescribed regimen in 2017. PI-based regimen decreased from 17.0% to 0.7% during the study period. We found that changes of initial ART between 2011 and 2017 were common, consist with the changes of National Imbursement Guideline for HIV therapy in Taiwan. We found a trend of rapidly increasing INI-based regimen and decreasing PI-based regimen during the study period. Shorten time window for initiating ART was found according to reimbursement regulation of STR as the first-line therapy and government policy of same-day HIV testing and treatment initiation. The persistence of ART was influenced by treatment guideline during the study period.