Choice of the initial antiretroviral treatment for HIV-positive individuals in the era of integrase inhibitors

BACKGROUND: We aimed to describe the most frequently prescribed initial antiretroviral therapy (ART) regimens in recent years in HIV-positive persons in the Cohort of the Spanish HIV/AIDS Research Network (CoRIS) and to investigate factors associated with the choice of each regimen. METHODS: We analyzed initial ART regimens prescribed in adults participating in CoRIS from 2014 to 2017. Only regimens prescribed in >5% of patients were considered. We used multivariable multinomial regression to estimate Relative Risk Ratios (RRRs) for the association between sociodemographic and clinical characteristics and the choice of the initial regimen. RESULTS: Among 2874 participants, abacavir(ABC)/lamivudine(3TC)/dolutegavir(DTG) was the most frequently prescribed regimen (32.1%), followed by tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC)/elvitegravir(EVG)/cobicistat(COBI) (14.9%), TDF/FTC/rilpivirine (RPV) (14.0%), tenofovir alafenamide (TAF)/FTC/EVG/COBI (13.7%), TDF/FTC+DTG (10.0%), TDF/FTC+darunavir/ritonavir or darunavir/cobicistat (bDRV) (9.8%) and TDF/FTC+raltegravir (RAL) (5.6%). Compared with ABC/3TC/DTG, starting TDF/FTC/RPV was less likely in patients with CD4100.000 copies/mL. TDF/FTC+DTG was more frequent in those with CD4100.000 copies/mL. TDF/FTC+RAL and TDF/FTC+bDRV were also more frequent among patients with CD4<200 cells//muL and with transmission categories other than men who have sex with men. Compared with ABC/3TC/DTG, the prescription of other initial ART regimens decreased from 2014-2015 to 2016-2017 with the exception of TDF/FTC+DTG. Differences in the choice of the initial ART regimen were observed by hospitals' location. CONCLUSIONS: The choice of initial ART regimens is consistent with Spanish guidelines' recommendations, but is also clearly influenced by physician's perception based on patient's clinical and sociodemographic variables and by the prescribing hospital location

Rela??es filogen?ticas das esp?cies da fam?lia Callichthyidae : (Ostariophysi, Siluriformes)

Made available in DSpace on 2015-04-14T13:09:42Z (GMT). No. of bitstreams: 1 451889.pdf: 4456883 bytes, checksum: e742e45558fe54b9dfa42a4657b631fb (MD5) Previous issue date: 2013-08-28The phylogeny of the family Callichthyidae (Siluriformes) was investigated performing a Cladistic parsimony analysis under a Total Evidence approach. Characters explored are mainly based in osteology and molecular data of nuclear and mitochondrial genes. The ingroup included 131 terminals representing 111 species, the outgroup included 13 terminals representing 13 species including Copionodon as the rooting taxa. The phylogenetic analysis resulted in 89 most parsimonious trees which are summarized in a strict consensus cladogram; a new phylogenetic classification and the discussion of this paper are addressed based in this topology. The Total Evidence phylogenetic analysis corroborated the monophyly of the family Callichthyidae, subfamilies Callichthyinae and Corydoradinae, genera Callichthys, Dianema, Lepthoplosternum, Megalechis, and Scleromystax. However, the genera Aspidoras, Corydoras, and Hoplosternum are recovered nonmonophyletic. To reconcile this situation, a revalidation of the genera Hoplisoma and Gastrodermus is proposed to accommodate most species currently recognized in Corydoras. Aspidoras virgulatus and Corydoras lacerdai are transferred to Scleromystax to conceive their currently containing genera monophyletic. On the other hand, Hoplosternum is recovered paraphyletic. However, it was decided to hold making taxonomic changes at this moment until molecular dataset is completed for this genus, which is referred temporarily as Hoplosternum . Synapomorphies for each clade recovered and ranked in the phylogenetic classification are reported here, emphasizing their morphological diagnoses. Interrelationships between species and clades are discussed and compared with previous taxonomic and phylogenetic hypotheses. In addition, the taxonomy of Hoplisoma nattereri was reviewed in order to elucidate its synonymy and investigate the presence of cryptic diversity under this name. Hoplisoma nattereri and H. triseriatus are considered valid species. Geographic distribution for each species is also reported. Corydoras juquiaae is removed from the synonymy of Hoplisoma nattereri and transferred to Scleromystax juquiaae, new combination. Scleromystax prionotos is considered a junior synonym of S. juquiaae. All these species are illustrated in this paper. In addition, the original figure of S. juquiaae prepared but never published by Rudolph von Ihering is reproduced here. Phylogenetic relationships of Hoplisoma nattereri and H. triseriatus are discussed and also the morphometric and genetic distance of some of the populations sampled.A filogenia da fam?lia Callichthyidae (Siluriformes) foi estudada realizando uma an?lise de Parcim?nia Clad?stica sob uma abordagem de Evid?ncia Total. Caracteres explorados foram principalmente baseados em osteologia e dados moleculares de genes nucleares e mitocondriais. O grupo interno incluiu 131 terminais representando 111 esp?cies; o grupo externo incluiu 13 terminais representando 13 esp?cies e incluindo Copionodon como o terminal de enraizamento da topologia. A an?lise filogen?tica resultou em 89 ?rvores mais parcimoniosas que foram resumidas em um cladograma de consenso estrito; com base nessa topologia, se prop?e e discute uma nova classifica??o filogen?tica para Callichthyidae. A an?lise filogen?tica de Evid?ncia Total corroborou o monofiletismo da fam?lia Callichthyidae, subfam?lias Callichthyinae e Corydoradinae, g?neros Callichthys, Dianema, Lepthoplosternum, Megalechis e Scleromystax. No entanto, os g?neros Aspidoras, Corydoras e Hoplosternum foram recuperados n?omonofil?ticos. Para conciliar esta situa??o, se prop?e a revalida??o dos g?neros Hoplisoma e Gastrodermus para acomodar a maioria das esp?cies atualmente reconhecidas em Corydoras. Aspidoras virgulatus e Corydoras lacerdai foram transferidas para Scleromystax e assim conceber esses g?neros como monofil?ticos. Por outro lado, as esp?cies de Hoplosternum foram recuperadas como parafil?ticas. No entanto, decidiu-se n?o fazer mudan?as taxon?micas no momento at? concluir a coleta de dados moleculares para este grupo, o qual ? reconhecido temporariamente como Hoplosternum. Sinapomorfias para cada clado recuperado e proposto na classifica??o filogen?tica s?o aqui mostrados, enfatizando seus caracteres morfol?gicos diagn?sticos. Inter-rela??es entre as esp?cies e clados s?o discutidas e comparadas com estudos taxon?micos e hip?teses filogen?ticas anteriores. Adicionalmente, a taxonomia de Hoplisoma nattereri foi revisada a fim de elucidar sua sinon?mia e investigar a presen?a de diversidade cr?ptica sob este nome. Hoplisoma nattereri e H. triseriatus s?o consideradas esp?cies v?lidas. A distribui??o geogr?fica para cada esp?cie ? reportada. Corydoras juquiaae ? removida da sinon?mia de Hoplisoma nattereri e transferida para Scleromystax juquiaae, nova combina??o. Scleromystax prionotos ? considerada um sin?nimo j?nior de S. juquiaae. Todas estas esp?cies s?o ilustradas neste artigo. Tamb?m, a figura original de Corydoras juquiaae preparada, mas nunca publicada, por Rudolph von Ihering ? aqui reproduzida. As rela??es filogen?ticas de Hoplisoma nattereri e H. triseriatus foram discutidas como assim a sua morfometr?a e a dist?ncia gen?tica de algumas das popula??es amostradas