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Long-term effectiveness of recommended boosted protease inhibitor-based antiretroviral therapy in Europe

JR. Santos, A. Cozzi-Lepri, A. Phillips, S. De Wit, C. Pedersen, P. Reiss, A. Blaxhult, A. Lazzarin, M. Sluzhynska, C. Orkin, C. Duvivier, J. Bogner, P. Gargalianos-Kakolyris, P. Schmid, G. Hassoun, I. Khromova, M. Beniowski, V. Hadziosmanovic,...

. 2018 ; 19 (5) : 324-338. [pub] 20180201

Jazyk angličtina Země Anglie, Velká Británie

Typ dokumentu srovnávací studie, časopisecké články, pozorovací studie, práce podpořená grantem

Perzistentní odkaz   https://www.medvik.cz/link/bmc19028595
E-zdroje Online Plný text

NLK Free Medical Journals od 1999 do Před 2 roky
Medline Complete (EBSCOhost) od 1999-10-01 do Před 1 rokem
Wiley Free Content od 1999 do Před 2 roky

Odkazy

PubMed 29388732
DOI 10.1111/hiv.12581
Knihovny.cz E-zdroje

OBJECTIVES: The aim of the study was to evaluate the long-term response to antiretroviral treatment (ART) based on atazanavir/ritonavir (ATZ/r)-, darunavir/ritonavir (DRV/r)-, and lopinavir/ritonavir (LPV/r)-containing regimens. METHODS: Data were analysed for 5678 EuroSIDA-enrolled patients starting a DRV/r-, ATZ/r- or LPV/r-containing regimen between 1 January 2000 and 30 June 2013. Separate analyses were performed for the following subgroups of patients: (1) ART-naïve subjects (8%) at ritonavir-boosted protease inhibitor (PI/r) initiation; (2) ART-experienced individuals (44%) initiating the new PI/r with a viral load (VL) ≤500 HIV-1 RNA copies/mL; and (3) ART-experienced patients (48%) initiating the new PI/r with a VL >500 copies/mL. Virological failure (VF) was defined as two consecutive VL measurements >200 copies/mL ≥24 weeks after PI/r initiation. Kaplan-Meier and multivariable Cox models were used to compare risks of failure by PI/r-based regimen. The main analysis was performed with intention-to-treat (ITT) ignoring treatment switches. RESULTS: The time to VF favoured DRV/r over ATZ/r, and both were superior to LPV/r (log-rank test; P < 0.02) in all analyses. Nevertheless, the risk of VF in ART-naïve patients was similar regardless of the PI/r initiated after controlling for potential confounders. The risk of VF in both treatment-experienced groups was lower for DRV/r than for ATZ/r, which, in turn, was lower than for LPV/r-based ART. CONCLUSIONS: Although confounding by indication and calendar year cannot be completely ruled out, in ART-experienced subjects the long-term effectiveness of DRV/r-containing regimens appears to be greater than that of ATZ/r and LPV/r.

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