Dataset Information

Lopinavir/r no longer recommended as a first-line regimen: a comparative effectiveness analysis.

ABSTRACT:

Introduction

We compared the effectiveness of tenofovir/emtricitabine (TDF/FTC) combined with either lopinavir/r (LPV/r) or another recommended third drug in the 2010 French guidelines in antiretroviral-naïve patients starting combination antiretroviral therapy in 2004-2008 in the French Hospital Database on HIV.

Methods

The outcomes were stop or switch of the third component, viral load (VL) <500 copies/ml, an increase of at least 100 CD4 cells/mm(3), AIDS-defining event and non-AIDS-defining hospitalization or death. Propensity scores were estimated by logistic regression based on the clinical centre and other confounders. In each clinical centre, each patient initiating LPV/r was matched with a patient initiating another third drug (efavirenz or atazanavir/r) and having a close propensity score. Cox's proportional hazards models were then used, with treatment as covariate. Time was right-censored at four years.

Results

1269 patients started LPV/r plus TDF/FTC, and 890 could be matched to 890 patients receiving another third drug. Baseline characteristics were well balanced between these two groups. LPV/r was associated with a higher risk of third drug stop (hazard ratio (HR): 1.69; 95% confidence interval (CI), 1.42-2.00) and with less rapid viral suppression (HR: 0.83; 95% CI, 0.72-0.95). There was no difference in the time required for a CD4 cell increment of at least 100/mm(3), or to the occurrence of an AIDS-defining event. Non-AIDS-defining hospitalizations or deaths were more frequent with LPV/r (HR: 1.79; 95% CI, 1.33-2.39).

Conclusions

For first-line therapy, in this observational setting, TDF/FTC plus LPV/r were less durable than TDF/FTC plus another recommended third drug, led to a less rapid viral suppression and were associated with a higher risk of non-AIDS morbidity.

SUBMITTER: Potard V

PROVIDER: S-EPMC4176690 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Publications

Lopinavir/r no longer recommended as a first-line regimen: a comparative effectiveness analysis.

Potard Valérie V Rey David D Poizot-Martin Isabelle I Mokhtari Saadia S Pradier Christian C Rozenbaum Willy W Brun-Vezinet Françoise F Costagliola Dominique D

Journal of the International AIDS Society 20140925

<h4>Introduction</h4>We compared the effectiveness of tenofovir/emtricitabine (TDF/FTC) combined with either lopinavir/r (LPV/r) or another recommended third drug in the 2010 French guidelines in antiretroviral-naïve patients starting combination antiretroviral therapy in 2004-2008 in the French Hospital Database on HIV.<h4>Methods</h4>The outcomes were stop or switch of the third component, viral load (VL) <500 copies/ml, an increase of at least 100 CD4 cells/mm(3), AIDS-defining event and non- ...[more]

PMID: 25261780

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Dataset Information

Lopinavir/r no longer recommended as a first-line regimen: a comparative effectiveness analysis.

Introduction

Methods

Results

Conclusions

Publications

Lopinavir/r no longer recommended as a first-line regimen: a comparative effectiveness analysis.

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