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ABSTRACT: Background
There are no data comparing the response to PI/r-based regimens in people presenting for care with low CD4 counts or AIDS (LC).Aim
To compare the response to LPV/r-, DRV/r- or ATV/r-based cART regimens in LC initiating cART from ART-naive.Methods
We included people enrolled in Icona with either CD4 counts ?350 cells/mm3 (low CD4-LC) or CD4 counts ?200 cells/mm3 (very low CD4-VLC) and/or AIDS, starting their first PI/r-based regimen after 2008. Initial regimens were compared by intention-to-treat: i) time to viral failure (VF) (first of 2 consecutive VL>200 copies/mL after?6 months); II) time to PI/r discontinuation/switching for any cause (TD) and for toxicity (TDT); III) treatment failure (TF) (VF or TD). Kaplan-Meier and Cox analyses were used.Results
1,362 LC patients were included (DRV/r 607; ATV/r 552; LPV/r 203); 813 VLC. In a median of 18 months (IQR:7-35), the 1-year probability of VF and TF were 2.8% (1.9-3.8) and 21.1% (18.7-23.4). In the adjusted analysis, patients initiating ATV/r had a 53% lower chance, and those initiating DRV/r a 61% lower chance of TD, as compared to LPV/r; the risk of TF was more likely in people starting LPV/r. Results were similar among VLC; in this subgroup LPV/r including regimens demonstrated a lower chance of VF.Conclusions
We confirmed in LC a low chance of virological failure by 1 year, with small differences according to PI/r. However, larger differences were observed when comparing longer-term endpoints such as treatment failure. These results are important for people presenting late for care.
SUBMITTER: d'Arminio Monforte A
PROVIDER: S-EPMC4922579 | biostudies-literature | 2016
REPOSITORIES: biostudies-literature
d'Arminio Monforte Antonella A Cozzi-Lepri Alessandro A Maggiolo Franco F Rizzardini Giuliano G Manconi Paolo Emilio PE Gianotti Nicola N Quirino Tiziana T Pinnetti Carmela C Rusconi Stefano S De Luca Andrea A Antinori Andrea A
PloS one 20160627 6
<h4>Background</h4>There are no data comparing the response to PI/r-based regimens in people presenting for care with low CD4 counts or AIDS (LC).<h4>Aim</h4>To compare the response to LPV/r-, DRV/r- or ATV/r-based cART regimens in LC initiating cART from ART-naive.<h4>Methods</h4>We included people enrolled in Icona with either CD4 counts ≤350 cells/mm3 (low CD4-LC) or CD4 counts ≤200 cells/mm3 (very low CD4-VLC) and/or AIDS, starting their first PI/r-based regimen after 2008. Initial regimens ...[more]