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RESEARCH PRODUCT
Duration of first-line antiretroviral therapy with tenofovir and emtricitabine combined with atazanavir/ritonavir, efavirenz or lopinavir/ritonavir in the Italian ARCA cohort.
A Di BiagioR PrinaporiD GiannarelliF MaggioloS Di GiambenedettoV BorghiG PencoP CicconiD FrancisciG SterrantinoA ZoncadaL MonnoA CapettiA GiacomettiVincenzo Vullo Arca Collaborative Groupsubject
CyclopropanesTime FactorsPyridinesPyridineDrug ResistanceLopinavir/ritonavirLongitudinal StudieHIV InfectionsPharmacologyAntiviral therapyDeoxycytidineLopinavirCohort Studieschemistry.chemical_compoundimmune system diseasesRetrospective StudieOrganophosphonateMedicineEmtricitabineHIV InfectionPharmacology (medical)ViralLongitudinal StudiesProspective StudiesProspective cohort studyvirus diseasesLopinavirInfectious DiseasesAnti-Retroviral AgentsItalyAlkynesCombinationOligopeptideHIV/AIDSDrug Therapy CombinationOligopeptidesmedicine.drugHumanMicrobiology (medical)Benzoxazinemedicine.medical_specialtyEfavirenzTime Factorantiretroviral therapyAtazanavir SulfateOrganophosphonatesfirst-line therapy tenofovir emtricitabine atazanavir/ritonavirSettore MED/17 - MALATTIE INFETTIVEEmtricitabineDurabilityDrug TherapyInternal medicineDrug Resistance ViralDrug utilizationHumansAntiviral therapy; Drug utilization; Durability; HIV/AIDS; Tenofovir/emtricitabine; Adenine; Anti-Retroviral Agents; Benzoxazines; Cohort Studies; Deoxycytidine; Drug Resistance Viral; Drug Therapy Combination; HIV Infections; HIV-1; Humans; Italy; Longitudinal Studies; Lopinavir; Oligopeptides; Organophosphonates; Prospective Studies; Pyridines; Retrospective Studies; Ritonavir; Time Factors; Pharmacology; Pharmacology (medical); Infectious DiseasesTenofovirRetrospective StudiesAntiviral therapy; Drug utilization; Durability; HIV/AIDS; Tenofovir/emtricitabine; Adenine; Anti-Retroviral Agents; Atazanavir Sulfate; Benzoxazines; Cohort Studies; Deoxycytidine; Drug Resistance Viral; Drug Therapy Combination; Emtricitabine; HIV Infections; HIV-1; Humans; Italy; Longitudinal Studies; Lopinavir; Oligopeptides; Organophosphonates; Prospective Studies; Pyridines; Retrospective Studies; Ritonavir; Tenofovir; Time FactorsPharmacologyRitonavirbusiness.industryAdenineAtazanavirBenzoxazinesRegimenProspective StudiechemistryHIV-1RitonavirAnti-Retroviral AgentCohort StudieTenofovir/emtricitabinebusinessdescription
Objectives: To explore the durability of three first-line tenofovir/emtricitabine-based regimens in combination with atazanavir/ritonavir, efavirenz or lopinavir/ritonavir in HIV-1-infected patients. Patients and methods: A retrospective, longitudinal, multicentre analysis of adult patients enrolled in the Antiretroviral Resistance Cohort Analysis (ARCA), a national prospective observational cohort of HIV-1-infected patients followed up at more than 100 clinical and laboratory units in Italy. Patients eligible were those starting first-line antiretroviral therapy between 1 June 2004 and 15 April 2011 and who were followed up for at least 6 months. The primary endpoint was durability, defined as the time from antiretroviral therapy initiation to first treatment modification. Time-dependent events were analysed by the Kaplan-Meier approach and the Cox proportional hazard model. Results: There are 26 000 HIV-infected patients in the ARCA database, of whom 1654 met study inclusion criteria. Six hundred and thirty-nine (38.6%) received efavirenz, 321 (19.4%) received atazanavir/ritonavir and 694 (41.9%) received lopinavir/ritonavir as a first-line regimen. Over a total observation period of 88 months, equivalent to more than 2805 person-years of follow-up, 618 patients underwent treatment modification. Lopinavir/ritonavir, given twice daily, was associated with a higher discontinuation rate than efavirenz- and atazanavir-based regimens [hazard ratio (HR) 1.83, 95% confidence interval (CI) 1.56-2.15, P = 0.001]. Comparing the once-daily regimens, the rate of discontinuation of efavirenz was higher than that of atazanavir/ritonavir (HR 1.39, 95% CI 1.06-1.83, P = 0.016). Conclusions: Significant differences in treatment duration were observed among the three studied regimens. Once-daily regimens exhibited greater durability than the twice-daily regimen. Among the specific regimens examined, tenofovir/emtricitabine plus atazanavir/ritonavir showed the greatest durability. © The Author 2012. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2013-01-01 |