| Differential effects of efavirenz, lopinavir/r, and atazanavir/r on the initial viral decay rate in treatment naïve HIV-1-infected patients. | |
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MedLine Citation:
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PMID: 20455766 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Clinical Trial, Phase IV; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: AIDS research and human retroviruses Volume: 26 ISSN: 1931-8405 ISO Abbreviation: AIDS Res. Hum. Retroviruses Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-05-18 Completed Date: 2010-08-24 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8709376 Medline TA: AIDS Res Hum Retroviruses Country: United States |
Other Details:
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Languages: eng Pagination: 533-40 Citation Subset: IM; X |
Affiliation:
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Department of Infectious Diseases, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden. arvid.eden@vgregion.se |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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 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:
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0/Anti-HIV Agents; 0/Benzoxazines; 0/Oligopeptides; 0/Pyridines; 0/Pyrimidinones; 0/RNA, Viral; 0/Reverse Transcriptase Inhibitors; 154635-17-3/efavirenz; 192725-17-0/lopinavir; 198904-31-3/atazanavir |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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