Effects of antiretroviral resistance on outcomes and health care resource utilisation among people with HIV in the United States and Europe: a real-world survey

HIV Res Clin Pract. 2025 Dec;26(1):2526910. doi: 10.1080/25787489.2025.2526910. Epub 2025 Jul 9.

Abstract

Background: Despite advances in antiretroviral therapy (ART), resistance remains a barrier to effective HIV treatment. Objective: This study evaluated associations between ART drug resistance and treatment adherence, health care resource utilisation (HCRU), and quality of life (QoL) among people with HIV. Methods: A retrospective, observational study was conducted using the Adelphi HIV Disease Specific Programme (DSP) between 2021 and 2023 across the United States and Europe. Data were collected via physician surveys, patient record forms, and patient self-completion forms. Results: Data for 2006 people with HIV and resistance testing were contributed by 290 physicians, and 586 people with HIV provided patient data. Overall, 286 people with HIV (14%) had documented resistance. People with HIV with resistance had received more ART regimens than those without resistance (p < 0.0001) and had lower viral suppression rates (p = 0.004) and lower CD4 counts (p = 0.032). People with HIV with resistance reported lower treatment adherence (p = 0.017) but similar QoL compared to those without resistance. People with HIV with resistance also had significantly more HIV-related hospitalisations than those without resistance (p = 0.022). Conclusions: ART resistance was associated with higher HCRU and poorer health outcomes in people with HIV, underscoring the need for continued focus on adherence and resistance management.

Keywords: Antiretroviral therapy; drug resistance; health care resource utilisation; patient-reported outcomes; people with HIV.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Anti-HIV Agents* / therapeutic use
  • Anti-Retroviral Agents* / therapeutic use
  • CD4 Lymphocyte Count
  • Drug Resistance, Viral*
  • Europe / epidemiology
  • Female
  • HIV Infections* / drug therapy
  • HIV Infections* / epidemiology
  • HIV Infections* / virology
  • Health Resources / statistics & numerical data
  • Humans
  • Male
  • Medication Adherence
  • Middle Aged
  • Patient Acceptance of Health Care* / statistics & numerical data
  • Quality of Life
  • Retrospective Studies
  • Surveys and Questionnaires
  • United States / epidemiology

Substances

  • Anti-HIV Agents
  • Anti-Retroviral Agents