82; 95% CI 0.69–0.98, P=0.03] compared with the early period; however, a global likelihood ratio test comparing

nested models provided no evidence of a significant difference in the rate of discontinuation for any reason according to calendar period of starting HAART (P=0.08). The relative hazard for the recent vs. early period was in the opposite direction to that expected on the basis of the Kaplan–Meier estimates: the confounder was the HAART regimen started. Actually, patients who started a boosted PI (ARH 1.63; 95% CI 1.31–2.02, P<.0001) had higher risk of discontinuation compared with those who started an NNRTI-based combination, and most of them started HAART more recently (30% between 2000 and 2002 and 60% after 2002). Similarly, patients who stared a three-NRTI combination were at higher risk of discontinuing at least one drug in their first regimen (ARH 1.63; 95% CI 1.22–2.18, P=0.009), and only NVP-BEZ235 in vivo 1.7% selleck chemicals of them started in the early period. Women were more likely than men to change initial HAART (ARH 1.27; 95% CI 1.10–1.47, P=0.0009), and HIV/HCV-coinfected patients had a higher risk of discontinuation (ARH 1.18; 95% CI 1.00–1.41, P=0.04 vs. HIV mono-infected patients) (Table 2). By 1 year the probability of discontinuation

because of intolerance/toxicity was 23.2% (95% CI 21.1–25.3%) among patients who started HAART in the early period, 22.3% (95% CI 19.4–25.1%) among patients who started HAART in the intermediate period and 20.8% (95% CI 17.5–24.2) among patients who started HAART in recent period (log rank test P=0.61) (Fig. 1). In the multivariable Cox model, the probability of discontinuation because of intolerance/toxicity was significantly Methocarbamol lower in patients who started HAART more recently (2003–2007, ARH 0.67, 95% CI 0.51–0.89, P=0.006 vs. 1997–1999). Thus the multivariable analysis confirmed the results obtained with the Kaplan–Meier method. Patients who started treatment with a boosted PI had a higher risk of discontinuing because of intolerance/toxicity (ARH 1.66, 95% CI 1.25–2.20 vs. single PI) as did HIV/HCV-coinfected

patients (AHR 1.33, 95% CI 1.07–1.66 vs. HIV mono-infected patients; P=0.008) and female patients (AHR 1.32, 95% CI 1.10–1.59 vs. male patients; P=0.002) (Table 3). By 1 year, the probability of discontinuation because of poor adherence was 14.7% (95% CI 12.7–16.8%) among patients who started HAART in the early period, 10.9% (95% CI 8.4–13.4%) among patients who started HAART in the intermediate period and 10.5% (95% CI 7.4–13.6%) among patients who started HAART in the recent period (log rank test P=0.02) (Fig. 1). However, in the multivariable model, the probability of discontinuation because of poor adherence did not significantly differ according to calendar period of starting HAART: the ARHs were 0.85 (95% CI 0.59–1.21, P=0.36) among those who started in the intermediate period and 1.00 (95% CI 0.64–1.