Document Detail


Differential effects of efavirenz, lopinavir/r, and atazanavir/r on the initial viral decay rate in treatment naïve HIV-1-infected patients.
MedLine Citation:
PMID:  20455766     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Initial viral decay rate may be useful when comparing the relative potency of antiretroviral regimens. Two hundred twenty-seven ART-naïve patients were randomized to receive efavirenz (EFV) (n = 74), lopinavir/ritonavir (LPV/r) (n = 77), or atazanavir/ritonavir (ATV/r) (n = 79) in combination with two NRTIs. The most frequently used NRTI combinations in the EFV and ATV/r groups were the nonthymidine analogues tenofovir and emtricitabine or lamivudine (70% and 68%, respectively) and, in the LPV/r group, lamivudine and the thymidine analogue zidovudine (89%). HIV-1 RNA was monitored during the first 28 days after treatment initiation. Phase 1 and 2 decay rate was estimated in a subset of 157 patients by RNA decrease from days 0 to 7, and days 14 to 28. One-way ANOVA and subsequent Tukey's post hoc tests were used for groupwise comparisons. Mean (95% CI) HIV-1 RNA reductions from days 0 to 28 were 2.59 (2.45-2.73), 2.42 (2.27-2.57), and 2.13 (2.01-2.25) log(10) copies/ml for the EFV-, LPV/r-, and ATV/r-based treatment groups, respectively, with a significantly larger decrease in the EFV-based group at all time points compared with ATV/r (p < 0.0001), and with LPV/r at days 7-21 (p < 0.0001-0.03). LPV/r gave a greater RNA decrease compared with ATV/r from day 14 (p = 0.02). Phase 1 decay rate was significantly higher in the EFV group compared with LPV/r (p = 0.003) or ATV/r (p < 0.0001). No difference was found in phase 2 decrease. EFV-based treatment gave a more rapid decline in HIV-1 RNA than did either of the boosted protease inhibitor-based regimens. The observed differences may reflect different inherent regimen potencies.
Authors:
Arvid Edén; Lars-Magnus Andersson; Orjan Andersson; Leo Flamholc; Filip Josephson; Staffan Nilsson; Vidar Ormaasen; Veronica Svedhem; Christer Säll; Anders Sönnerborg; Petra Tunbäck; Magnus Gisslén
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Publication Detail:
Type:  Clinical Trial, Phase IV; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  AIDS research and human retroviruses     Volume:  26     ISSN:  1931-8405     ISO Abbreviation:  AIDS Res. Hum. Retroviruses     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-18     Completed Date:  2010-08-24     Revised Date:  2014-02-06    
Medline Journal Info:
Nlm Unique ID:  8709376     Medline TA:  AIDS Res Hum Retroviruses     Country:  United States    
Other Details:
Languages:  eng     Pagination:  533-40     Citation Subset:  IM; X    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anti-HIV Agents* / pharmacology,  therapeutic use
Benzoxazines* / pharmacology,  therapeutic use
Drug Therapy, Combination
Female
HIV Infections / drug therapy*,  virology
HIV-1 / drug effects*
Humans
Lopinavir
Male
Middle Aged
Oligopeptides* / pharmacology,  therapeutic use
Pyridines* / pharmacology,  therapeutic use
Pyrimidinones* / pharmacology,  therapeutic use
RNA, Viral / blood,  drug effects*
Reverse Transcriptase Inhibitors* / pharmacology,  therapeutic use
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-HIV Agents; 0/Benzoxazines; 0/Oligopeptides; 0/Pyridines; 0/Pyrimidinones; 0/RNA, Viral; 0/Reverse Transcriptase Inhibitors; 2494G1JF75/Lopinavir; JE6H2O27P8/efavirenz; QZU4H47A3S/atazanavir

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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