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RESEARCH PRODUCT
Impact of body weight on virological and immunological responses to efavirenz-containing regimens in HIV-infected, treatment-naive adults
Catia MarzoliniCaroline SabinFrancois RaffiMarco SiccardiCristina MussiniOdile LaunayDavid BurgerBernardino RocaJan FehrStefano BonoraAmanda MocroftNiels ObelFrederic-antoine DauchyRobert ZangerleCharalambos GogosNicola GianottiAdriana AmmassariCarlo TortiJade GhosnGenevieve CheneJesper GrarupManuel BattegayObesity Project Team On Behalf Of The Collaborationof Observational Hiv Epidemiological Research Europe (Cohere)in Eurocoord For TheefavirenzAntonella Castagnasubject
CyclopropanesMaleEfavirenz; HIV; Immunological response; Virological response; Weight; Adult; Antiretroviral Therapy Highly Active; Benzoxazines; CD4 Lymphocyte Count; Cohort Studies; Female; HIV Infections; Humans; Male; Middle Aged; Obesity; Regression Analysis; Reverse Transcriptase Inhibitors; Treatment Outcome; Viral Load; Body WeightHIV InfectionsOverweight10234 Clinic for Infectious DiseasesCohort Studieschemistry.chemical_compoundAntiretroviral Therapy Highly ActiveImmunology and AllergyHIV InfectionImmunological responsevirus diseasesVirological responseMiddle AgedViral LoadReverse Transcriptase InhibitorTreatment OutcomeInfectious DiseasesAlkynesCohort2723 Immunology and AllergyRegression AnalysisReverse Transcriptase InhibitorsFemalemedicine.symptomViral loadCohort studyHumanBenzoxazineAdultmedicine.medical_specialtyEfavirenzImmunologyAntiretroviral Therapy610 Medicine & healthRegression AnalysiPharmacokineticsInternal medicinemedicineHumansHighly ActiveObesity2403 Immunologybusiness.industryProportional hazards modelBody WeightHIV2725 Infectious DiseasesEfavirenz; HIV; Immunological response; Virological response; Weight; Adult; Antiretroviral Therapy Highly Active; Benzoxazines; CD4 Lymphocyte Count; Cohort Studies; Female; HIV Infections; Humans; Male; Middle Aged; Obesity; Regression Analysis; Reverse Transcriptase Inhibitors; Treatment Outcome; Viral Load; Body Weight; Immunology and Allergy; Immunology; Infectious Diseasesmedicine.diseaseWeightObesityBenzoxazinesCD4 Lymphocyte Countlnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4]chemistryImmunologyCohort StudieEfavirenzbusinessdescription
Objective: The prevalence of overweight and obesity is increasing among HIV-infected patients. Whether standard antiretroviral drug dosage is adequate in heavy individuals remains unresolved. We assessed the virological and immunological responses to initial efavirenz (EFV)-containing regimens in heavy compared to normal-weight HIV-infected patients. Design: Observational European cohort collaboration study. Methods: Eligible patients were antiretroviral-naive with documented weight prior to EFV start and follow-up viral loads after treatment initiation. Cox regression analyses evaluated the association between weight and time to first undetectable viral load ( 50 copies/ml) after initial suppression over 5 years of follow-up. Recovery of CD4(+) cell count was evaluated 6 and 12 months after EFV initiation. Analyses were stratified by weight (kg) group (I - 55, 80, 85, 90, 95). Results: The study included 19 968 patients, of whom 9.1, 68.3, 9.1, 5.8, 3.5, and 4.3% were in weight groups I-VI, respectively. Overall, 81.1% patients attained virological suppression, of whom 34.1% subsequently experienced viral load rebound. After multiple adjustments, no statistical difference was observed in time to undetectable viral load and virological rebound for heavier individuals compared to their normal weight counterparts. Although heaviest individuals had significantly higher CD4(+) cell count at baseline, CD4(+) cell recovery at 6 and 12 months after EFV initiation was comparable to normal-weight individuals. Conclusion: Virological and immunological responses to initial EFV-containing regimens were not impaired in heavy individuals, suggesting that the standard 600 mg EFV dosage is appropriate across a wide weight range. (C) 2015 Wolters Kluwer Health, Inc. All rights reserved
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2015-01-14 |