| Comparison of antiviral activity of regimens containing nucleos(t)ide (NUC) Pairs in HIV-Infected Patients Initiating REScue therapy (The NUCREST Study). | |
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MedLine Citation:
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PMID: 21126959 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: recycling nucleos(t)ides (NUCs) is useful in regions where new antiretrovirals are not available. This study compares the effectiveness of NUC-containing regimens as rescue therapy in routine care. METHODS: retrospective, multicentre cohort study (January 2001 to June 2006) of patients with ≥ 1 virological failure who started therapy with 2 NUCs and 1 non-nucleoside reverse transcriptase inhibitor (NNRTI) or a protease inhibitor (PI). The primary endpoint was the rate of treatment response at 6 months (intention-to-treat [ITT] analysis). RESULTS: we included 719 patients (average of 4 prior regimens over a median 6.1 years). The most frequent NUC pairs were tenofovir plus lamivudine (TDF+3TC; 25%), tenofovir plus stavudine (TDF+d4T; 23%), and stavudine plus didanosine (d4T+ddI; 15%). A boosted PI was used in 68% of total cases. Resistance to both NUCs was more frequent in zidovudine plus lamivudine (AZT+3TC; 22.0%), abacavir plus lamivudine (ABC+3TC; 35.5%), and stavudine plus lamivudine (d4T+3TC; 31.2%). No significant differences were observed in treatment response (overall 65%, P = .67); ddI+3TC (71%) and d4T+3TC (53%) had the highest and lowest response rates, respectively. Median time to failure was shorter with d4T+3TC, d4T+ddI, and ABC+3TC (48, 51, and 58 weeks, respectively; P = .0012). Lower response rates associated with an increasing number of thymidine analog mutations (TAMs) were observed for ABC+3TC (P = .027). CONCLUSION: the clinical utility of NUCs for rescue therapy is limited and selection should be individualized. Specific combinations (d4T+3TC and d4T+ddI) might be less efficacious. |
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Authors:
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J A Pérez-Molina; O Serrano; A Milinkovic; P Domingo; A Currán; H Knobel; G Gaspar; A Rodrigo; M J Jiménez-Expósito; B Hernández-Novoa; S Moreno; The NUCREST Study |
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Publication Detail:
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Type: Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: HIV clinical trials Volume: 11 ISSN: 1528-4336 ISO Abbreviation: HIV Clin Trials Publication Date: 2010 Sep-Oct |
Date Detail:
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Created Date: 2010-12-03 Completed Date: 2011-01-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100936377 Medline TA: HIV Clin Trials Country: United States |
Other Details:
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Languages: eng Pagination: 294-302 Citation Subset: IM |
Affiliation:
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Infectious Diseases, Hospital Ramón y Cajal, Madrid, Spain. jose.perezmolina@gmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Cohort Studies Female HIV* HIV Infections / blood, drug therapy*, immunology, virology Humans Male RNA, Viral / blood Retrospective Studies Reverse Transcriptase Inhibitors / administration & dosage* |
| Chemical | |
Reg. No./Substance:
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0/RNA, Viral; 0/Reverse Transcriptase Inhibitors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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