You are here

Switching to boosted protease inhibitor plus a second antiretroviral drug (dual therapy) for treatment simplification: a multicenter observational study.

TitleSwitching to boosted protease inhibitor plus a second antiretroviral drug (dual therapy) for treatment simplification: a multicenter observational study.
Publication TypeJournal Article
Year of Publication2016
AuthorsLatini A, Fabbiani M, Borghi V, Sterrantino G, Giannetti A, Lorenzini P, Loiacono L, Ammassari A, Bellagamba R, Colafigli M, D'Ettorre G, Di Giambenedetto S, Antinori A, Zaccarelli M
JournalBMC Infect Dis
Volume16
Issue1
Pagination401
Date Published2016 Aug 11
ISSN1471-2334
KeywordsAnti-HIV Agents, Antiretroviral Therapy, Highly Active, CD4 Lymphocyte Count, Darunavir, Drug Therapy, Combination, Female, Follow-Up Studies, HIV Infections, HIV Protease Inhibitors, Humans, Lamivudine, Lopinavir, Male, Medication Adherence, Middle Aged, Proportional Hazards Models, Raltegravir Potassium, Retrospective Studies, Risk, Tenofovir
Abstract

BACKGROUND: Aim of the study was to assess predictors of discontinuation/toxicity of boosted PI-based (PI/r) dual therapy (DT).

METHODS: Observational, retrospective switch study in patients successfully treated with triple drugs regimen. Patients switched to PI/r based DT [darunavir (DRV/r), lopinavir (LPV/r) or atazanavir (ATV/r)] plus a second drug: [raltegravir (RAL), maraviroc (MVC) etravirine (ETR), lamivudine (3TC) or tenofovir (TDF)] between 2009 and 2014 were included. The effect of each drug as well as other clinical and virological cofactors over treatment discontinuation (TD) was assessed using survival analysis.

RESULTS: Overall, 376 patients were included with mean follow-up of 73 weeks. The most commonly used drugs in DT were DRV/r (63.0 %) and RAL (53.7 %). TD was observed in 77 (20,4 %) patients: 38 (10,1 %) virological failure, 35 (9,3 %) toxicity/intolerance (4 deaths) and 4 (1 %) interruptions for patients decision. At Cox Model, adjusted by demographic and laboratory variables, DRV/r and ATV/r significantly reduced the likelihood of TD and longer treatment was associated with lower risk, while low CD4 count at baseline and number of previous regimens with a higher risk. Moreover, RAL and 3TC use were significantly associated with lower TD by toxicity.

CONCLUSIONS: In our clinical practice experience, switching virologically suppressed patients to PI/r based DT showed adequate safety and efficacy, so that it may be used in selected patients with specific medical needs.

DOI10.1186/s12879-016-1703-z
Alternate JournalBMC Infect. Dis.
PubMed ID27515949
PubMed Central IDPMC4982404