{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T09:01:34Z","timestamp":1777453294934,"version":"3.51.4"},"reference-count":46,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Antiviral Therapy"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore the durability of multi-drug antiretroviral regimens in treatment-experienced PWH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This retrospective observational study including PWH who started mega-ART regimens between 1 January 2009 and 31 December 2019, selected from the ARCA cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Time-dependent events were analysed by Kaplan\u2013Meier methods, while Cox regression models were used to define the predictors of mega-ART discontinuation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 1,514 ART-experienced PWH were included. Over a median follow-up of 47 weeks (IQR 15\u2013127), 1,299 (83%) mega-ART were interrupted, with an incidence of 85.62 per 100 person-years of follow-up. In the multivariable analysis, predictors of higher risk of mega-ART discontinuation were a higher number of antiretroviral drugs included in baseline regimens (aHR 1.206, CI 95% 1.016\u20131.431,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = .032) and a higher baseline HIV RNA log\n                      <jats:sub>10<\/jats:sub>\n                      (aHR 1.113, CI 95% 1.048\u20131.181,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; .001); otherwise, shorter duration of previous ART was associated with a lower risk of discontinuation (aHR 0.982, CI 95% 0.965\u20130.999,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = .037). When mega-ART was stopped, 299 PWH (23%) had HIV RNA levels above 50 copies\/ml, 16\/299 (1%) had HIV RNA levels &gt;50 copies\/ml but less than 200 copies\/ml, 792 PWH (61%) had HIV RNA levels below 50 copies\/ml, and 208 PWH (16%) had an undetermined HIV RNA load.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Mega-ART was characterized by limited durability and poor virological success.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13596535251317054","type":"journal-article","created":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T15:11:56Z","timestamp":1744643516000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Durability of multi-drug antiretroviral therapy (mega-ART) in treatment-experienced people with HIV in the ARCA database"],"prefix":"10.1177","volume":"30","author":[{"given":"Laura","family":"Labate","sequence":"first","affiliation":[{"name":"University of Genoa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Rossetti","sequence":"additional","affiliation":[{"name":"Misericordia Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Russo","sequence":"additional","affiliation":[{"name":"University of Genoa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Cassol","sequence":"additional","affiliation":[{"name":"Misericordia Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martina","family":"Bottanelli","sequence":"additional","affiliation":[{"name":"Vita-Salute San Raffaele University"},{"name":"San Raffaele Scientific Institute"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecka","family":"Papaioannu Borjesson","sequence":"additional","affiliation":[{"name":"Vita-Salute San Raffaele University"},{"name":"San Raffaele Scientific Institute"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Rancan","sequence":"additional","affiliation":[{"name":"University of Siena"},{"name":"University Hospital of Siena"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fiorenza","family":"Bracchitta","sequence":"additional","affiliation":[{"name":"L. Sacco University Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucia","family":"Graziani","sequence":"additional","affiliation":[{"name":"University of Florence"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Tilli","sequence":"additional","affiliation":[{"name":"University of Florence"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Costanza","family":"Malcontenti","sequence":"additional","affiliation":[{"name":"Careggi University and Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Mora","sequence":"additional","affiliation":[{"name":"University of Genoa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9921-3684","authenticated-orcid":false,"given":"Antonia","family":"Bezenchek","sequence":"additional","affiliation":[{"name":"InformaPRO S.r.l."},{"name":"EURESIST Network GEIE"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian","family":"Shallvari","sequence":"additional","affiliation":[{"name":"InformaPRO S.r.l."},{"name":"EURESIST Network GEIE"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurizio","family":"Zazzi","sequence":"additional","affiliation":[{"name":"University of Siena"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1436-5089","authenticated-orcid":false,"given":"Antonio","family":"Di Biagio","sequence":"additional","affiliation":[{"name":"University of Genoa"},{"name":"San Martino Hospital, IRCCS for Oncology and Neuroscience"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,4,14]]},"reference":[{"key":"e_1_3_4_2_2","volume-title":"Guidelines for the use of antiretroviral agents in adults and adolescents with HIV","author":"Panel on Antiretroviral Guidelines for Adults and Adolescents","year":"2023","unstructured":"Panel on Antiretroviral Guidelines for Adults and Adolescents. 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