We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Duration of first-line antiretroviral therapy with tenofovir and emtricitabine combined with atazanavir/ritonavir, efavirenz or lopinavir/ritonavir in the Italian ARCA cohort.
- Authors
Di Biagio, Antonio; Prinapori, Roberta; Giannarelli, Diana; Maggiolo, Franco; Di Giambenedetto, Simona; Borghi, Vanni; Penco, Giovanni; Cicconi, Paola; Francisci, Daniela; Sterrantino, Gaetana; Zoncada, Alessia; Monno, Laura; Capetti, Amedeo; Giacometti, Andrea
- Abstract
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.
- Subjects
ANTIRETROVIRAL agents; HIV-positive persons; LOPINAVIR-ritonavir; RITONAVIR; TENOFOVIR; EMTRICITABINE; THERAPEUTICS
- Publication
Journal of Antimicrobial Chemotherapy (JAC), 2013, Vol 68, Issue 1, p200
- ISSN
0305-7453
- Publication type
Article