{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T17:06:22Z","timestamp":1768323982890,"version":"3.49.0"},"reference-count":33,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2019,12,4]],"date-time":"2019-12-04T00:00:00Z","timestamp":1575417600000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010877","name":"ViiV Healthcare","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010877","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern AIDS Soc"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Two\u2010drug regimens (2\u2010DR) have the potential to be a viable solution to the challenges of treatment complexity, cost, adverse effects and contraindications. We sought to describe the real\u2010world use and effectiveness of 2\u2010DR among persons living with HIV (PLHIV) in the United States.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analysed data for 10,190 treatment\u2010experienced patients from the OPERA\u00ae Observational Database initiating a new 2\u2010DR or three\u2010drug regimen (3\u2010DR) between 1 January 2010 and 30 June 2016. Multivariate Cox Proportional Hazards models were used to estimate the association among 2\u2010DR or 3\u2010DR initiation and virologic suppression (viral load (VL) &lt;50\u00a0copies\/mL), virologic failure (2 VLs\u00a0&gt;\u00a0200\u00a0copies\/mL or 1 VL\u00a0&gt;\u00a0200\u00a0copies\/mL\u00a0+\u00a0discontinuation) or regimen discontinuation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients initiating a 2\u2010DR (n\u00a0=\u00a01337, 13%) were older, and more likely to have a lower CD4 count, a history of AIDS and comorbid conditions than patients initiating a 3\u2010DR. There was no difference between groups in time to virologic suppression (aHR: 1.00 (95% CI: 0.88, 1.13)) among viraemic patients (baseline VL\u00a0\u2265\u00a050 copies\/mL, n\u00a0=\u00a04180), or time to virologic failure (aHR: 1.15 (95% CI: 0.90, 1.48)) among virologically stable patients (baseline VL\u00a0&lt;\u00a050 copies\/mL, n\u00a0=\u00a06010). However, time to discontinuation was shorter following 2\u2010DR than 3\u2010DR initiation (aHR: 1.51 (95% CI: 1.41, 1.61)).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this large cohort of treatment\u2010experienced patients, 2\u2010DR prescriptions were common and more frequent among patients with significant comorbidity. Virologic response was similar, but duration of use was shorter with a 2\u2010DR than a 3\u2010DR, suggesting that 2\u2010DRs may be a virologically effective treatment strategy for treatment\u2010experienced PLHIV with existing comorbidities.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25418","type":"journal-article","created":{"date-parts":[[2019,12,5]],"date-time":"2019-12-05T07:53:01Z","timestamp":1575532381000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Two\u2010drug antiretroviral regimens: an assessment of virologic response and durability among treatment\u2010experienced persons living with HIV in the OPERA<sup>\u00ae<\/sup> Observational Database"],"prefix":"10.1002","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0159-7243","authenticated-orcid":false,"given":"Gerald","family":"Pierone","sequence":"first","affiliation":[{"name":"Whole Family Health Center Vero Beach FL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4566-1174","authenticated-orcid":false,"given":"Cassidy","family":"Henegar","sequence":"additional","affiliation":[{"name":"ViiV Healthcare Research Triangle Park NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1556-811X","authenticated-orcid":false,"given":"Jennifer","family":"Fusco","sequence":"additional","affiliation":[{"name":"Epividian, Inc Durham NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0157-9689","authenticated-orcid":false,"given":"Vani","family":"Vannappagari","sequence":"additional","affiliation":[{"name":"ViiV Healthcare Research Triangle Park NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5878-0060","authenticated-orcid":false,"given":"Michael","family":"Aboud","sequence":"additional","affiliation":[{"name":"ViiV Healthcare London United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9847-1879","authenticated-orcid":false,"given":"Leigh","family":"Ragone","sequence":"additional","affiliation":[{"name":"ViiV Healthcare Research Triangle Park NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6834-784X","authenticated-orcid":false,"given":"Gregory","family":"Fusco","sequence":"additional","affiliation":[{"name":"Epividian, Inc Durham NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,12,4]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0000000000000248"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2011.01.022"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0059551"},{"key":"e_1_2_9_5_1","unstructured":"Panel on Antiretroviral Guidelines for Adults and Adolescent.Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents Living with HIV Department of Health and Human Services.2018[cited 2018 Aug 14]. 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