{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T20:07:25Z","timestamp":1790021245304,"version":"4.0.1"},"reference-count":33,"publisher":"Instituto Nacional de Salud (Colombia)","issue":"3","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003033","name":"Ministerio de Ciencia, Tecnolog\u00eda e Innovaci\u00f3n","doi-asserted-by":"publisher","award":["934-2023"],"award-info":[{"award-number":["934-2023"]}],"id":[{"id":"10.13039\/501100003033","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["revistabiomedica.org"],"crossmark-restriction":false},"short-container-title":["Biomed."],"abstract":"<jats:p>Introducci\u00f3n. La terapia antirretroviral de gran actividad ha demostrado mejorar la supervivencia a largo plazo de los pacientes con HIV. Sin embargo, una proporci\u00f3n considerable de pacientes presenta fracaso o falla virol\u00f3gica durante el tratamiento.Objetivo. Determinar la relaci\u00f3n entre la polimedicaci\u00f3n, el cambio de tratamiento, la falta de adhesi\u00f3n y el no reclamar el medicamento, y la falla virol\u00f3gica de los pacientes con HIV que recibieron tratamiento antirretroviral.Materiales y m\u00e9todos. Se llev\u00f3 a cabo un estudio observacional de corte transversal con an\u00e1lisis multivariado de personas con HIV en tratamiento antirretroviral atendidos en una instituci\u00f3n de salud colombiana entre el 2007 y el 2022, de un censo de 4441 pacientes, en el que se calcul\u00f3 la regresi\u00f3n log\u00edstica binaria m\u00faltiple con fines explicativos y se calcularon los odds ratios crudos y ajustados, los intervalos de confianza y el valor de p. Resultados. La proporci\u00f3n de falla virol\u00f3gica fue del 28,1 %. En el modelo ajustado se demostr\u00f3 que la polimedicaci\u00f3n, el cambio de tratamiento, la falta de adhesi\u00f3n al tratamiento y el no reclamar el medicamento, explicaban de manera significativa la falla virol\u00f3gica.Conclusiones. La polimedicaci\u00f3n, el cambio de tratamiento, la falta de adhesi\u00f3n al tratamiento y el no reclamar el medicamento, son variables que explican la falla virol\u00f3gica de los pacientes con HIV que recib\u00edan terapia antirretroviral.<\/jats:p>","DOI":"10.7705\/biomedica.7947","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T13:09:31Z","timestamp":1788268171000},"page":"445-455","update-policy":"https:\/\/doi.org\/10.7705\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Fracaso virol\u00f3gico de la terapia antirretroviral en pacientes na\u00efve con HIV: una mirada desde variables farmacol\u00f3gicas","Virological failure in HIV-na\u00efve patients with antiretroviral therapy: A perspective from pharmacological variables"],"prefix":"10.7705","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4123-2812","authenticated-orcid":false,"given":"Carlos Alberto","family":"G\u00f3mez-Mercado","sequence":"first","affiliation":[{"name":"Direcci\u00f3n de Generaci\u00f3n de Valor, Cielum Health, Medell\u00edn, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4167-4733","authenticated-orcid":false,"given":"Paulo Andr\u00e9s","family":"Giraldo-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Direcci\u00f3n de Generaci\u00f3n de Valor, Cielum Health, Medell\u00edn, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4404-186X","authenticated-orcid":false,"given":"Newar Andr\u00e9s","family":"Giraldo-Alz\u00e1te","sequence":"additional","affiliation":[{"name":"Direcci\u00f3n de Generaci\u00f3n de Valor, Cielum Health, Medell\u00edn, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7789-1062","authenticated-orcid":false,"given":"Ana Mar\u00eda","family":"Hincapi\u00e9-Zapata","sequence":"additional","affiliation":[{"name":"Direcci\u00f3n de Investigaci\u00f3n, Desarrollo e Innovaci\u00f3n, helPharma, Medell\u00edn, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8914-6732","authenticated-orcid":false,"given":"Juliana","family":"Madrigal-Cadavid","sequence":"additional","affiliation":[{"name":"Direcci\u00f3n de Investigaci\u00f3n, Desarrollo e Innovaci\u00f3n, helPharma, Medell\u00edn, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6721-9267","authenticated-orcid":false,"given":"Jorge Iv\u00e1n","family":"Estrada-Acevedo","sequence":"additional","affiliation":[{"name":"Facultad de Ciencias de la Vida y la Salud, Universidad CES, Medell\u00edn, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4444","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"167694","doi-asserted-by":"crossref","unstructured":"Antiretroviral Therapy Cohort Collaboration. Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: A collaborative analysis of cohort studies. Lancet HIV. 2017;4:e349-56. https:\/\/doi.org\/10.1016\/S2352-3018(17)30066-8","DOI":"10.1016\/S2352-3018(17)30066-8"},{"key":"167695","doi-asserted-by":"crossref","unstructured":"Boileau C, Nguyen VK, Sylla M, Machouf N, Chamberland A, Traor\u00e9 HA, et al. Low prevalence of detectable HIV plasma viremia in patients treated with antiretroviral therapy in Burkina Faso and Mali. J Acquir Immune Defic Syndr. 1999;48:476-84. https:\/\/doi.org\/10.1097\/QAI.0b013e31817dc416","DOI":"10.1097\/QAI.0b013e31817dc416"},{"key":"167696","doi-asserted-by":"crossref","unstructured":"Ahn MY, Jiamsakul A, Khusuwan S, Khol V, Pham TT, Chaiwarith R, et al. The influence of age-associated comorbidities on responses to combination antiretroviral therapy in older people living with HIV. J Int AIDS Soc. 2019;22:e25228. https:\/\/doi.org\/10.1002\/jia2.25228","DOI":"10.1002\/jia2.25228"},{"key":"167697","unstructured":"G\u00f3mez C, Madrigal-Cadavid J, Giraldo PA, Abad JM, Serna JA, Segura \u00c1, et al. Factors associated with virologic failure in HIV patients on antiretroviral therapy. Farm Hosp. 2022;46:282-9. https:\/\/www.revistafarmaciahospitalaria.es\/es-xarticulo-S1130634323001289"},{"key":"167698","doi-asserted-by":"crossref","unstructured":"Ahmed M, Merga H, Jarso H. Predictors of virological treatment failure among adult HIV patients on first-line antiretroviral therapy in Woldia and Dessie hospitals, Northeast Ethiopia: A case-control study. BMC Infect Dis. 2019;19:305. https:\/\/doi.org\/10.1186\/s12879-019-3924-4","DOI":"10.1186\/s12879-019-3924-4"},{"key":"167699","unstructured":"Arrieta-Mart\u00ednez JA, Estrada-Acevedo JI, G\u00f3mez CA, Madrigal-Cadavid J, Serna JA, Giraldo PA, et al. Factores relacionados con la no adherencia a la terapia antirretroviral en pacientes con VIH\/sida. Farm Hosp. 2022;46:319-26. https:\/\/doi.org\/10.7399\/fh.11793"},{"key":"167700","doi-asserted-by":"crossref","unstructured":"Tetteh RA, Nartey ET, Lartey M, Mantel-Teeuwisse AK, Leufkens HGM, Yankey BA, et al. Association between the occurrence of adverse drug events and modification of first line highly active antiretroviral therapy in Ghanaian HIV patients. Drug Saf. 2016;39:1139-49. https:\/\/doi.org\/10.1007\/s40264-016-0460-7","DOI":"10.1007\/s40264-016-0460-7"},{"key":"167701","doi-asserted-by":"crossref","unstructured":"Rusconi S, Santoro MM, Gianotti N, Antinori A, Bonora S, Cingolani A, et al. Is the rate of virological failure to cART continuing to decline in recent calendar years? J Clin Virol. 2019;116:23-8. https:\/\/doi.org\/10.1016\/j.jcv.2019.04.009","DOI":"10.1016\/j.jcv.2019.04.009"},{"key":"167702","doi-asserted-by":"crossref","unstructured":"Rodr\u00edguez Chamorro M\u00c1, Garc\u00eda Jim\u00e9nez E, Amariles P, Rodr\u00edguez Chamorro A, Jos\u00e9 Faus M. Revisi\u00f3n de tests de medici\u00f3n del cumplimiento terap\u00e9utico utilizados en la pr\u00e1ctica cl\u00ednica. Aten Primaria. 2008;40:413-7. https:\/\/doi.org\/10.1157\/13125407","DOI":"10.1157\/13125407"},{"key":"167703","unstructured":"Machado-Alba JE, Gonz\u00e1lez-Santos DM, Vidal-Guitart X. Efectividad del tratamiento antirretroviral en pacientes de Pereira y Manizales. Rev Salud P\u00fablica. 201;13:492-503."},{"key":"167704","doi-asserted-by":"crossref","unstructured":"Gunda DW, Kilonzo SB, Mtaki T, Bernard DM, Kalluvya SE, Shao ER. Magnitude and correlates of virological failure among adult HIV patients receiving PI based second line ART regimens in North Western Tanzania: A case control study. BMC Infect Dis. 2019;19:235. https:\/\/doi.org\/10.1186\/s12879-019-3852-3","DOI":"10.1186\/s12879-019-3852-3"},{"key":"167705","doi-asserted-by":"crossref","unstructured":"Kiweewa F, Esber A, Musingye E, Reed D, Crowell TA, Cham F, et al. HIV virologic failure and its predictors among HIV-infected adults on antiretroviral therapy in the African Cohort Study. PLOS One. 2019;14:e0211344. https:\/\/doi.org\/10.1371\/journal.pone.0211344","DOI":"10.1371\/journal.pone.0211344"},{"key":"167706","doi-asserted-by":"crossref","unstructured":"Zhao Y, Wu Z, McGoogan JM, Sha Y, Zhao D, Ma Y, et al. Nationwide cohort study of antiretroviral therapy timing: Treatment dropout and virological failure in China, 2011-2015. Clin Infect Dis. 2019;68:43-50. https:\/\/doi.org\/10.1093\/cid\/ciy400","DOI":"10.1093\/cid\/ciy400"},{"key":"167707","unstructured":"Amariles P, Giraldo N, Henao E. Gu\u00eda de actuaci\u00f3n farmac\u00e9utica en pacientes con VIH\/SIDA. Primera edici\u00f3n. Medell\u00edn: Universidad de Antioquia; 2006."},{"key":"167708","unstructured":"World Health Organization. Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring. Geneva: WHO; 2021."},{"key":"167709","unstructured":"US Department of Health and Human Services. Guidelines for the use of antiretroviral agents in adults and adolescents with HIV. Washington, D. C.: U.S. Department of Health and Human Services; 2025. Fecha de consulta: 2 de marzo de 2026. Disponible en: https:\/\/clinicalinfo.hiv.gov\/en\/guidelines"},{"key":"167710","doi-asserted-by":"crossref","unstructured":"Pag\u00e8s N, Valverde M. M\u00e9todos para medir la adherencia terap\u00e9utica. Ars Pharm. 2018;59:163-72. https:\/\/doi.org\/10.30827\/ars.v59i3.7387","DOI":"10.30827\/ars.v59i3.7387"},{"key":"167711","doi-asserted-by":"crossref","unstructured":"Urizar CA, Jarolin-Montiel M, Ayala-Servin N, Centuri\u00f3n-Wenninger C, Montiel-Garcete D. Factores asociados a la no adherencia del tratamiento antirretroviral en pacientes con VIH en un hospital de Paraguay. Rev Cient Cienc Med. 2021;23:166-74. https:\/\/doi.org\/10.51581\/rccm.v23i2.287","DOI":"10.51581\/rccm.v23i2.287"},{"key":"167712","doi-asserted-by":"crossref","unstructured":"Greenland S. Modeling and variable selection in epidemiologic analysis. Am J Public Health. 1989;79:340-9. https:\/\/doi.org\/10.2105\/ajph.79.3.340","DOI":"10.2105\/AJPH.79.3.340"},{"key":"167713","doi-asserted-by":"crossref","unstructured":"Salvana EMT, Samonte GMJ, Telan E, Leyritana K, Tactacan-Abrenica RJ, Ching PR, et al. High rates of tenofovir failure in a CRF01_AE-predominant HIV epidemic in the Philippines. Int J Infect Dis. 2020;93:114-20. https:\/\/doi.org\/10.1016\/j.ijid.2020.02.020","DOI":"10.1016\/j.ijid.2020.02.020"},{"key":"167714","doi-asserted-by":"crossref","unstructured":"Tagarro A, Chan M, Zangari P, Ferns B, Foster C, De Rossi A, et al. Early and highly suppressive antiretroviral therapy are main factors associated with low viral reservoir in European perinatally HIV-infected children. J Acquir Immune Defic Syndr. 2018;79:269-76. https:\/\/doi.org\/10.1097\/QAI.0000000000001789","DOI":"10.1097\/QAI.0000000000001789"},{"key":"167715","doi-asserted-by":"crossref","unstructured":"Young J, Bucher HC, Guenthard HF, Rickenbach M, Fux CA, Hirschel B, et al. Virological and immunological responses to efavirenz or boosted lopinavir as first line therapy for patients with HIV. Antivir Ther. 2009;14:771-9. https:\/\/doi.org\/10.3851\/IMP1291","DOI":"10.3851\/IMP1291"},{"key":"167716","unstructured":"Cuenta de Alto Costo. Situaci\u00f3n del VIH en Colombia 2024. Bogot\u00e1, D. C.: Cuenta de Alto Costo (CAC), Fondo Colombiano de Enfermedades de Alto Costo; 2025. Fecha de consulta: 2 de marzo de 2026. Disponible en: https:\/\/cuentadealtocosto.org\/noticias\/dia-mundial-dela-concientizacion-y-respuesta-al-vih\/"},{"key":"167717","doi-asserted-by":"crossref","unstructured":"De la Hoz J, Bola\u00f1o L, C\u00e1rdenas O, Gonz\u00e1lez R, Sabbag J, Palacio L, et al. Characterization of treatment failure in HIV positive patients in the Colombian Caribbean region. Colomb Med. 2014;45:162-7. https:\/\/doi.org\/10.25100\/cm.v45i4.1566","DOI":"10.25100\/cm.v45i4.1566"},{"key":"167718","doi-asserted-by":"crossref","unstructured":"Guaraldi G, Orlando G, Zona S, Menozzi M, Carli F, Garlassi E, et al. Premature age-related comorbidities among HIV-infected persons compared with the general population. Clin Infect Dis. 2011;53:1120-6. https:\/\/doi.org\/10.1093\/cid\/cir627","DOI":"10.1093\/cid\/cir627"},{"key":"167719","doi-asserted-by":"crossref","unstructured":"Marzolini C, Elzi L, Gibbons S, Weber R, Fux C, Furrer H, et al. Prevalence of comedications and effect of potential drug\u2013drug interactions in the Swiss HIV Cohort Study. Antivir Ther. 2010;15:413-23. https:\/\/doi.org\/10.3851\/IMP1540","DOI":"10.3851\/IMP1540"},{"key":"167720","doi-asserted-by":"crossref","unstructured":"Justice AC. HIV and aging: Time for a new paradigm. Curr HIV\/AIDS Rep. 2010;7:69-76. https:\/\/doi.org\/10.1007\/s11904-010-0041-9","DOI":"10.1007\/s11904-010-0041-9"},{"key":"167721","doi-asserted-by":"crossref","unstructured":"Glass TR, Sterne JAC, Schneider MP, De Geest S, Nicca D, Furrer H, et al. Self-reported nonadherence to antiretroviral therapy as a predictor of viral failure and mortality. AIDS. 2015;29:2195-200. https:\/\/doi.org\/10.1097\/QAD.0000000000000782","DOI":"10.1097\/QAD.0000000000000782"},{"key":"167722","doi-asserted-by":"crossref","unstructured":"Bircher RE, Ntamatungiro AJ, Glass TR, Mnzava D, Nyuri A, Mapesi H, et al. High failure rates of protease inhibitor-based antiretroviral treatment in rural Tanzania - A prospective cohort study. PLOS One. 2020;15:e0227600. https:\/\/doi.org\/10.1371\/journal.pone.0227600","DOI":"10.1371\/journal.pone.0227600"},{"key":"167723","doi-asserted-by":"crossref","unstructured":"Nanfuka M, Forrest JI, Zhang W, Okoboi S, Birungi J, Kaleebu P, et al. Durability of non-nucleotide reverse transcriptase inhibitor-based first-line ART regimens after 7 years of treatment in rural Uganda: A prospective cohort study. Medicine (Baltimore). 2021;100:e25763. https:\/\/doi.org\/10.1097\/MD.0000000000025763","DOI":"10.1097\/MD.0000000000025763"},{"key":"167724","doi-asserted-by":"crossref","unstructured":"Woodward B, Person A, Rebeiro P, Kheshti A, Raffanti S, Pettit A. Risk prediction tool for medical appointment attendance among HIV-infected persons with unsuppressed viremia. AIDS Patient Care STDs. 2015;29:240-7. https:\/\/doi.org\/10.1089\/apc.2014.0334","DOI":"10.1089\/apc.2014.0334"},{"key":"167725","doi-asserted-by":"crossref","unstructured":"Ben\u00edtez AE, Musinguzi N, Bangsberg DR, Bwana MB, Muzoora C, Hunt PW, et al. Super learner analysis of real-time electronically monitored adherence to antiretroviral therapy under constrained optimization and comparison to non-differentiated care approaches for persons living with HIV in rural Uganda. J Int AIDS Soc. 2020;23:e25467. https:\/\/doi.org\/10.1002\/jia2.25467","DOI":"10.1002\/jia2.25467"},{"key":"167726","doi-asserted-by":"crossref","unstructured":"Mantshonyane L, Roy J, Levy MZ, Wallis CL, Bar K, Godfrey C, et al. Participants switching to second-line antiretroviral therapy with susceptible virus display inferior adherence and worse outcomes: An observational analysis. AIDS Patient Care STDs. 2021;35:467-73. https:\/\/doi.org\/10.1089\/apc.2021.0115","DOI":"10.1089\/apc.2021.0115"}],"container-title":["Biom\u00e9dica"],"original-title":[],"link":[{"URL":"https:\/\/revistabiomedica.org\/index.php\/biomedica\/article\/download\/7947\/5961","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/revistabiomedica.org\/index.php\/biomedica\/article\/download\/7947\/5961","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T19:23:08Z","timestamp":1790018588000},"score":1,"resource":{"primary":{"URL":"https:\/\/revistabiomedica.org\/index.php\/biomedica\/article\/view\/7947"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,20]]},"references-count":33,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,8,20]]}},"URL":"https:\/\/doi.org\/10.7705\/biomedica.7947","relation":{},"ISSN":["2590-7379","0120-4157"],"issn-type":[{"value":"2590-7379","type":"electronic"},{"value":"0120-4157","type":"print"}],"subject":[],"published":{"date-parts":[[2026,8,20]]},"assertion":[{"value":"2026-08-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}},{"value":"Yes","order":0,"name":"peer_reviewed","label":"Peer Reviewed","group":{"name":"peer_review","label":"Peer Review"}},{"value":"Instituto Nacional de Salud","name":"publisher","label":"This article is maintained by"},{"value":"Biomedica","name":"journaltitle","label":"Journal Title"},{"value":"Art\u00edculos originales","name":"content_type","label":"Content Type"}]}}