Back to Search
Start Over
Boosted Lopinavir- Versus Boosted Atazanavir-Containing Regimens and Immunologic, Virologic, and Clinical Outcomes: A Prospective Study of HIV-Infected Individuals in High-Income Countries
- Source :
- Clinical infectious diseases, 60(8), 1262-1268. Oxford University Press, Clinical Infectious Diseases, Clinical Infectious Diseases, Oxford University Press (OUP), 2015, 60 (8), pp.1262-1268. ⟨10.1093/cid/ciu1167⟩, Clinical Infectious Diseases, 60(8), 1262-1268. Oxford University Press, Clinical Infectious Diseases, 60, 1262-8, Clinical Infectious Diseases, 60(8), 1262-8. Oxford University Press, Clinical Infectious Diseases, 60, 8, pp. 1262-8
- Publication Year :
- 2015
-
Abstract
- Current clinical guidelines consider regimens consisting of either ritonavir-boosted atazanavir or ritonavir-boosted lopinavir and a nucleoside reverse transcriptase inhibitor (NRTI) backbone among their recommended and alternative first-line antiretroviral regimens. However, these guidelines are based on limited evidence from randomized clinical trials and clinical experience.We compared these regimens with respect to clinical, immunologic, and virologic outcomes using data from prospective studies of human immunodeficiency virus (HIV)-infected individuals in Europe and the United States in the HIV-CAUSAL Collaboration, 2004-2013. Antiretroviral therapy-naive and AIDS-free individuals were followed from the time they started a lopinavir or an atazanavir regimen. We estimated the 'intention-to-treat' effect for atazanavir vs lopinavir regimens on each of the outcomes.A total of 6668 individuals started a lopinavir regimen (213 deaths, 457 AIDS-defining illnesses or deaths), and 4301 individuals started an atazanavir regimen (83 deaths, 157 AIDS-defining illnesses or deaths). The adjusted intention-to-treat hazard ratios for atazanavir vs lopinavir regimens were 0.70 (95% confidence interval [CI], .53-.91) for death, 0.67 (95% CI, .55-.82) for AIDS-defining illness or death, and 0.91 (95% CI, .84-.99) for virologic failure at 12 months. The mean 12-month increase in CD4 count was 8.15 (95% CI, -.13 to 16.43) cells/?L higher in the atazanavir group. Estimates differed by NRTI backbone.Our estimates are consistent with a lower mortality, a lower incidence of AIDS-defining illness, a greater 12-month increase in CD4 cell count, and a smaller risk of virologic failure at 12 months for atazanavir compared with lopinavir regimens.? The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.
- Subjects :
- Male
lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4]
HIV Infections
Cohort Studies
chemistry.chemical_compound
[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases
immune system diseases
Antiretroviral Therapy, Highly Active
Medicine
Prospective Studies
Cooperative Behavior
Prospective cohort study
atazanavir
Hazard ratio
virus diseases
Lopinavir
Middle Aged
Viral Load
Europe
Treatment Outcome
Infectious Diseases
[SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology
HIV/AIDS
[SDV.IMM]Life Sciences [q-bio]/Immunology
Female
Viral load
medicine.drug
Adult
Microbiology (medical)
medicine.medical_specialty
Efavirenz
Adolescent
Anti-HIV Agents
Atazanavir Sulfate
Young Adult
Internal medicine
Humans
observational studies
business.industry
Developed Countries
HIV
mortality
United States
CD4 Lymphocyte Count
Atazanavir
lopinavir
Regimen
chemistry
Immunology
business
Subjects
Details
- Language :
- English
- ISSN :
- 10584838 and 15376591
- Database :
- OpenAIRE
- Journal :
- Clinical infectious diseases, 60(8), 1262-1268. Oxford University Press, Clinical Infectious Diseases, Clinical Infectious Diseases, Oxford University Press (OUP), 2015, 60 (8), pp.1262-1268. ⟨10.1093/cid/ciu1167⟩, Clinical Infectious Diseases, 60(8), 1262-1268. Oxford University Press, Clinical Infectious Diseases, 60, 1262-8, Clinical Infectious Diseases, 60(8), 1262-8. Oxford University Press, Clinical Infectious Diseases, 60, 8, pp. 1262-8
- Accession number :
- edsair.doi.dedup.....d0a14e9dc8dd797739eba92f150c49b5