{"doi":"10.1093/cid/ciaa1878","title":"Clinical Outcomes of 2-Drug Regimens vs 3-Drug Regimens in Antiretroviral Treatment–Experienced People Living With Human Immunodeficiency Virus","abstract":"BACKGROUND: Limited data exist that compare clinical outcomes of 2-drug regimens (2DRs) and 3-drug regimens (3DRs) in people living with human immunodeficiency virus. METHODS: Antiretroviral treatment-experienced individuals in the International Cohort Consortium of Infectious Diseases (RESPOND) who switched to a new 2DR or 3DR from 1 January 2012-1 October 2018 were included. The incidence of clinical events (AIDS, non-AIDS cancer, cardiovascular disease, end-stage liver and renal disease, death) was compared between regimens using Poisson regression. RESULTS: Of 9791 individuals included, 1088 (11.1%) started 2DRs and 8703 (88.9%) started 3DRs. The most common 2DRs were dolutegravir plus lamivudine (22.8%) and raltegravir plus boosted darunavir (19.8%); the most common 3DR was dolutegravir plus 2 nucleoside reverse transcriptase inhibitors (46.9%). Individuals on 2DRs were older (median, 52.6 years [interquartile range, 46.7-59.0] vs 47.7 [39.7-54.3]), and a higher proportion had ≥1 comorbidity (81.6% vs 73.9%). There were 619 events during 27 159 person-years of follow-up (PYFU): 540 (incidence rate [IR] 22.5/1000 PYFU; 95% confidence interval [CI]: 20.7-24.5) on 3DRs and 79 (30.9/1000 PYFU; 95% CI: 24.8-38.5) on 2DRs. The most common events were death (7.5/1000 PYFU; 95% CI: 6.5-8.6) and non-AIDS cancer (5.8/1000 PYFU; 95% CI: 4.9-6.8). After adjustment for baseline demographic and clinical characteristics, there was a similar incidence of events on both regimen types (2DRs vs 3DRs IR ratio, 0.92; 95% CI: .72-1.19; P = .53). CONCLUSIONS: This is the first large, international cohort to assess clinical outcomes on 2DRs. After accounting for baseline characteristics, there was a similar incidence of events on 2DRs and 3DRs. 2DRs appear to be a viable treatment option with regard to clinical outcomes. Further research on resistance barriers and long-term durability of 2DRs is needed.","journal":"Clinical Infectious Diseases","year":2020,"id":68842,"datarank":0.7443418503839363,"base_score":3.1354942159291497,"endowment":3.1354942159291497,"self_citation_contribution":0.47032413238937254,"citation_network_contribution":0.2740177179945637,"self_endowment_contribution":0.47032413238937254,"citer_contribution":0.2740177179945637,"corpus_percentile":72.90167865707434,"corpus_rank":3504,"citation_count":22,"citer_count":14,"citers_with_citation_signal":10,"citers_with_endowment":10,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.5795,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":364591,"name":"Lene Ryom","orcid":"0000-0002-6436-6461","position":1,"is_corresponding":false},{"id":364592,"name":"Bastian Neesgaard","orcid":"0000-0003-0215-0144","position":2,"is_corresponding":false},{"id":364593,"name":"Gilles Wandeler","orcid":"0000-0002-5278-8763","position":3,"is_corresponding":false},{"id":364594,"name":"Thérèse Staub","orcid":"0000-0003-4898-4566","position":4,"is_corresponding":false},{"id":364595,"name":"Martin Gisinger","orcid":"0000-0002-2667-7074","position":5,"is_corresponding":false},{"id":365634,"name":"Michael Skoll","orcid":null,"position":6,"is_corresponding":false},{"id":69678,"name":"Huldrych F. Gunthard","orcid":"0000-0002-1142-6723","position":7,"is_corresponding":false},{"id":364596,"name":"Alexandra Scherrer","orcid":"0000-0003-4870-179X","position":8,"is_corresponding":false},{"id":364597,"name":"Cristina Mussini","orcid":"0000-0002-6615-4198","position":9,"is_corresponding":false},{"id":364598,"name":"Colette Smith","orcid":"0000-0003-2847-3355","position":10,"is_corresponding":false},{"id":364599,"name":"Margaret Johnson","orcid":"0000-0003-1330-7100","position":11,"is_corresponding":false},{"id":365635,"name":"Stéphane De Wit","orcid":null,"position":12,"is_corresponding":false},{"id":365636,"name":"Coca Necsoi","orcid":null,"position":13,"is_corresponding":false},{"id":364600,"name":"Christian Pradier","orcid":"0000-0002-0676-6379","position":14,"is_corresponding":false},{"id":241754,"name":"Ferdinand W.N.M. Wit","orcid":"0000-0003-2066-8115","position":15,"is_corresponding":false},{"id":74454,"name":"Clara Lehmann","orcid":"0000-0002-7042-1578","position":16,"is_corresponding":false},{"id":364601,"name":"Antonella d’Arminio Monforte","orcid":"0000-0003-0073-1789","position":17,"is_corresponding":false},{"id":346878,"name":"José M. Miró","orcid":"0000-0001-8057-7755","position":18,"is_corresponding":false},{"id":364602,"name":"Antonella Castagna","orcid":"0000-0002-8338-9714","position":19,"is_corresponding":false},{"id":364603,"name":"Vincenzo Spagnuolo","orcid":"0000-0002-9656-7217","position":20,"is_corresponding":false},{"id":104889,"name":"Anders Sönnerborg","orcid":"0000-0001-8928-3374","position":21,"is_corresponding":false},{"id":11862,"name":"Matthew Law","orcid":"0000-0002-3540-8837","position":22,"is_corresponding":false},{"id":364604,"name":"Jolie Hutchinson","orcid":"0000-0003-1936-3808","position":23,"is_corresponding":false},{"id":364605,"name":"Nikoloz Chkhartishvili","orcid":"0000-0002-1309-825X","position":24,"is_corresponding":false},{"id":365637,"name":"N Bolokadze","orcid":null,"position":25,"is_corresponding":false},{"id":365638,"name":"Jan‐Christian Wasmuth","orcid":null,"position":26,"is_corresponding":false},{"id":364606,"name":"Christoph Stephan","orcid":"0000-0003-3777-9006","position":27,"is_corresponding":false},{"id":364607,"name":"Vani Vannappagari","orcid":"0000-0002-0157-9689","position":28,"is_corresponding":false},{"id":365639,"name":"Felipe Rogatto","orcid":null,"position":29,"is_corresponding":false},{"id":364608,"name":"Josep M. Llibre","orcid":"0000-0002-7158-6753","position":30,"is_corresponding":false},{"id":364609,"name":"Claudine Duvivier","orcid":"0000-0001-5696-4173","position":31,"is_corresponding":false},{"id":12029,"name":"Jennifer Hoy","orcid":"0000-0002-6948-7086","position":32,"is_corresponding":false},{"id":364610,"name":"Mark Bloch","orcid":"0000-0002-1143-5013","position":33,"is_corresponding":false},{"id":35803,"name":"Heiner C. Bucher","orcid":"0000-0002-0131-7873","position":34,"is_corresponding":false},{"id":364611,"name":"Alexandra Calmy","orcid":"0000-0002-1137-6826","position":35,"is_corresponding":false},{"id":365640,"name":"Alain Volny Anne","orcid":null,"position":36,"is_corresponding":false},{"id":364612,"name":"Annegret Pelchen–Matthews","orcid":"0000-0002-0994-5655","position":37,"is_corresponding":false},{"id":12038,"name":"Jens Lundgren","orcid":"0000-0001-8901-7850","position":38,"is_corresponding":false},{"id":365641,"name":"Lars Peters","orcid":null,"position":39,"is_corresponding":false},{"id":364613,"name":"Loveleen Bansi‐Matharu","orcid":"0000-0002-0233-7622","position":40,"is_corresponding":false},{"id":364614,"name":"Amanda Mocroft","orcid":"0000-0001-8316-1122","position":41,"is_corresponding":false},{"id":241759,"name":"Peter Reiss","orcid":"0000-0001-7896-6428","position":43,"is_corresponding":false},{"id":365642,"name":"M Hillebregt","orcid":null,"position":44,"is_corresponding":false},{"id":364615,"name":"Kathy Petoumenos","orcid":"0000-0001-7534-7154","position":46,"is_corresponding":false},{"id":364616,"name":"Norman Rose","orcid":"0000-0002-2908-205X","position":47,"is_corresponding":false},{"id":364617,"name":"Robert Zangerle","orcid":"0000-0002-5375-7299","position":48,"is_corresponding":false},{"id":365643,"name":"H Appoyer","orcid":null,"position":49,"is_corresponding":false},{"id":365644,"name":"M Delforge","orcid":null,"position":51,"is_corresponding":false},{"id":365645,"name":"M Bucht","orcid":null,"position":54,"is_corresponding":false},{"id":364618,"name":"Otar Chokoshvili","orcid":"0000-0003-3023-1902","position":56,"is_corresponding":false},{"id":365646,"name":"A Rodano","orcid":null,"position":58,"is_corresponding":false},{"id":364619,"name":"Alessandro Tavelli","orcid":"0000-0001-5899-451X","position":59,"is_corresponding":false},{"id":365647,"name":"Iuri Fanti","orcid":null,"position":60,"is_corresponding":false},{"id":365648,"name":"Vanni Borghi","orcid":null,"position":62,"is_corresponding":false},{"id":364620,"name":"Éric Fontas","orcid":"0000-0002-1849-9626","position":64,"is_corresponding":false},{"id":365649,"name":"K Dollet","orcid":null,"position":65,"is_corresponding":false},{"id":365650,"name":"C Caissotti","orcid":null,"position":66,"is_corresponding":false},{"id":365651,"name":"J Casabona","orcid":null,"position":67,"is_corresponding":false},{"id":364621,"name":"Antoni Riéra","orcid":"0000-0001-7142-7675","position":70,"is_corresponding":false},{"id":365652,"name":"J. Uruena","orcid":null,"position":71,"is_corresponding":false},{"id":364622,"name":"Fiona Lampe","orcid":"0000-0001-6851-5471","position":73,"is_corresponding":false},{"id":364623,"name":"Adriano Lazzarin","orcid":"0000-0003-2551-7754","position":75,"is_corresponding":false},{"id":364624,"name":"Andrea Poli","orcid":"0000-0001-7163-9627","position":76,"is_corresponding":false},{"id":365653,"name":"A Sönnerborg","orcid":null,"position":77,"is_corresponding":false},{"id":365654,"name":"Karolin Falconer","orcid":null,"position":78,"is_corresponding":false},{"id":365655,"name":"V Svedhem","orcid":null,"position":79,"is_corresponding":false},{"id":365656,"name":"B Ledergerber","orcid":null,"position":81,"is_corresponding":false},{"id":365657,"name":"J C Wasmuth","orcid":null,"position":84,"is_corresponding":false},{"id":28526,"name":"Jörg Janne Vehreschild","orcid":"0000-0002-5446-7170","position":85,"is_corresponding":false},{"id":103447,"name":"Gerd Fätkenheuer","orcid":"0000-0002-5054-1871","position":86,"is_corresponding":false},{"id":255291,"name":"James F. Rooney","orcid":"0000-0003-3261-0711","position":88,"is_corresponding":false},{"id":365658,"name":"H Garges","orcid":null,"position":91,"is_corresponding":false},{"id":364590,"name":"Lauren Greenberg","orcid":"0000-0003-1554-0408","position":0,"is_corresponding":true}],"reference_count":36,"raw_metadata":null,"created_at":"2026-07-18T21:41:52.279368Z","pmid":"33354721","pmcid":"PMC9431658","fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}