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.

therapeutic use

Treatment Outcome

pharmacology

Drug Therapy

Combination

therapeutic use

therapeutic use

Male

pharmacology

therapeutic use

Pyrimidinones

HIV-1

RNA

Humans

Middle Aged

Viral

Benzoxazines

Female

pharmacology

Oligopeptides

Reverse Transcriptase Inhibitors

therapeutic use

HIV Infections

drug effects

Adult

drug therapy

Aged

pharmacology

therapeutic use

Anti-HIV Agents

Pyridines

virology

pharmacology

pharmacology

drug effects

blood

Författare

Arvid Edén

Göteborgs universitet

L. M. Andersson

Göteborgs universitet

Orjan Andersson

Sundsvall Hospital

Leo Flamholc

Skånes universitetssjukhus (SUS)

Filip Josephson

Karolinska universitetssjukhuset

Staffan Nilsson

Göteborgs universitet

Chalmers, Matematiska vetenskaper, matematisk statistik

Vidar Ormaasen

Ullevål hospital

Veronica Svedhem

Karolinska universitetssjukhuset

Christer Säll

Boras Hospital

A. Sonnerborg

Karolinska Institutet

Karolinska universitetssjukhuset

Petra Tunbäck

Göteborgs universitet

Magnus Gisslén

Göteborgs universitet

AIDS research and human retroviruses

1931-8405 (ISSN)

Vol. 26 5 533-40

Ämneskategorier

Infektionsmedicin

Mikrobiologi inom det medicinska området

DOI

10.1089/aid.2009.0177

PubMed

20455766