1. Virologic Effectiveness of Abacavir/Lamivudine with Darunavir/Ritonavir Versus Other Protease Inhibitors in Treatment-Experienced HIV-Infected Patients in Clinical Practice
- Author
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Cassidy Henegar, Anthony Mills, Ricky Hsu, Philip Lackey, Felix Carpio, Gerald Pierone, Mike Wohlfeiler, Edwin DeJesus, Jennifer S Fusco, and Gregory Fusco
- Subjects
Adult ,Male ,0301 basic medicine ,Oncology ,medicine.medical_specialty ,Anti-HIV Agents ,030106 microbiology ,HIV Infections ,Emtricitabine ,03 medical and health sciences ,0302 clinical medicine ,Abacavir ,Internal medicine ,medicine ,Humans ,Pharmacology (medical) ,Prospective Studies ,Original Research Article ,030212 general & internal medicine ,Darunavir ,Ritonavir ,business.industry ,virus diseases ,Lamivudine ,HIV Protease Inhibitors ,General Medicine ,Abacavir/Lamivudine ,Middle Aged ,Viral Load ,Virology ,Dideoxynucleosides ,CD4 Lymphocyte Count ,Drug Combinations ,Regimen ,Female ,business ,Viral load ,medicine.drug - Abstract
Background and Objectives The standard of care for HIV treatment is a three-drug regimen consisting of two nucleoside reverse transcriptase inhibitors (NRTIs) and either a non-nucleoside reverse transcriptase inhibitor, a protease inhibitor (PI) or an integrase strand transfer inhibitor. Darunavir boosted with ritonavir (DRV/r) is the only preferred PI in the US Department of Health and Human Services (DHHS) HIV treatment guidelines for antiretroviral-naïve patients, recommended in combination with tenofovir/emtricitabine for antiretroviral-naïve patients. For treatment-experienced and certain antiretroviral-naïve patients, abacavir and lamivudine (ABC/3TC) in combination with DRV/r is considered an effective and tolerable alternative, despite limited research on the effectiveness of this particular combination. This study evaluated virologic outcomes in treatment-experienced patients taking ABC/3TC + DRV/r compared to treatment-experienced patients taking ABC/3TC with any other PI. Methods Treatment-experienced HIV-infected patients initiating their first regimen containing ABC/3TC in combination with any PI in the year 2005 or later were selected from the Observational Pharmaco-Epidemiology Research and Analysis (OPERA®) cohort, a prospective observational cohort reflecting routine medical care. Viral load measurements taken during follow-up were compared between patients taking ABC/3TC + DRV/r and ABC/3TC with a PI other than DRV/r. Logistic regression models were fit to assess the association between regimen exposure and viral load suppression. Results A total of 151 patients initiating ABC/3TC + DRV/r and 525 patients initiating ABC/3TC + a non-darunavir PI were included. Patients in both treatment groups had comparable clinical indicators (viral load, CD4) at baseline. A regimen of ABC/3TC + DRV/r was more likely to be prescribed in the later years of the study period, leading to a shorter median follow-up in the DRV/r treatment group (as-treated analysis: 14 vs. 17 months, p = 0.04; intent-to-treat analysis: 33 vs. 68 months, p
- Published
- 2016
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