Differential effects of efavirenz, lopinavir/r, and atazanavir/r on the initial viral decay rate in treatment naïve HIV-1-infected patients.
Artikel i vetenskaplig tidskrift, 2010
Initial viral decay rate may be useful when comparing the relative potency of antiretroviral regimens. Two hundred twenty-seven ART-naïve patients were randomized to receive efavirenz (EFV) (n = 74), lopinavir/ritonavir (LPV/r) (n = 77), or atazanavir/ritonavir (ATV/r) (n = 79) in combination with two NRTIs. The most frequently used NRTI combinations in the EFV and ATV/r groups were the nonthymidine analogues tenofovir and emtricitabine or lamivudine (70% and 68%, respectively) and, in the LPV/r group, lamivudine and the thymidine analogue zidovudine (89%). HIV-1 RNA was monitored during the first 28 days after treatment initiation. Phase 1 and 2 decay rate was estimated in a subset of 157 patients by RNA decrease from days 0 to 7, and days 14 to 28. One-way ANOVA and subsequent Tukey's post hoc tests were used for groupwise comparisons. Mean (95% CI) HIV-1 RNA reductions from days 0 to 28 were 2.59 (2.45-2.73), 2.42 (2.27-2.57), and 2.13 (2.01-2.25) log(10) copies/ml for the EFV-, LPV/r-, and ATV/r-based treatment groups, respectively, with a significantly larger decrease in the EFV-based group at all time points compared with ATV/r (p < 0.0001), and with LPV/r at days 7-21 (p < 0.0001-0.03). LPV/r gave a greater RNA decrease compared with ATV/r from day 14 (p = 0.02). Phase 1 decay rate was significantly higher in the EFV group compared with LPV/r (p = 0.003) or ATV/r (p < 0.0001). No difference was found in phase 2 decrease. EFV-based treatment gave a more rapid decline in HIV-1 RNA than did either of the boosted protease inhibitor-based regimens. The observed differences may reflect different inherent regimen potencies.
pharmacology
therapeutic use
Treatment Outcome
Aged
Adult
Humans
HIV Infections
Benzoxazines
HIV-1
Middle Aged
blood
Drug Therapy
Pyrimidinones
RNA
pharmacology
Combination
therapeutic use
pharmacology
therapeutic use
Reverse Transcriptase Inhibitors
Anti-HIV Agents
drug effects
therapeutic use
Male
virology
pharmacology
Pyridines
therapeutic use
pharmacology
pharmacology
Viral
Female
Oligopeptides
drug therapy
therapeutic use
drug effects
Författare
Arvid Edén
Göteborgs universitet
L. M. Andersson
Göteborgs universitet
Orjan Andersson
Sundsvall Hospital
Leo Flamholc
Malmo University Hospital
Filip Josephson
Karolinska University Hospital
Staffan Nilsson
Chalmers, Matematiska vetenskaper, matematisk statistik
Göteborgs universitet
Vidar Ormaasen
Ullevål hospital
Veronica Svedhem
Karolinska University Hospital
Christer Säll
Boras Hospital
A. Sonnerborg
Karolinska University Hospital
Karolinska Institutet
Petra Tunbäck
Göteborgs universitet
Magnus Gisslén
Göteborgs universitet
AIDS research and human retroviruses
1931-8405 (ISSN)
Vol. 26 5 533-40Ämneskategorier (SSIF 2011)
Infektionsmedicin
Mikrobiologi inom det medicinska området
DOI
10.1089/aid.2009.0177
PubMed
20455766