|Title||Switching to boosted protease inhibitor plus a second antiretroviral drug (dual therapy) for treatment simplification: a multicenter observational study.|
|Publication Type||Journal Article|
|Year of Publication||2016|
|Authors||Latini 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|
|Journal||BMC Infect Dis|
|Date Published||2016 Aug 11|
|Keywords||Anti-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|
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.
|Alternate Journal||BMC Infect. Dis.|
|PubMed Central ID||PMC4982404|