Protease-sparing regimen in a real-life practice with naïve patients: an equal opportunity approach?

Abstract:

PURPOSE:Proven clinical efficacy of protease-sparing regimens (PSR) has been shown. Concerns exist about broad applicability of these regimens in advanced naïve patients. Recent reports have associated a rise in liver enzymes with nevi rapine; however, no data exist with efavirenz. METHOD:17 consecutive antiretroviral-naïve HIV patients were started on a PSR with efavirenz plus two nucleoside reverse transcriptase inhibitors. Baseline liver enzymes, serum CD38, CD4, and HIV viral load data were collected. Correlation between change in viral load and immune reconstitution on therapy were compared to baseline laboratory values. RESULTS:All patients had a mean viral load decrease of >2 logs, including patients with low initial CD4% or high viral load, and there was no increase of liver enzymes observed at a median follow-up of 42 weeks (range 17-78). There was a perfect correlation between the change in viral load and the initial viral load (p <.0001, r = 1.00) including patients with viral load > or =100,000 copies/mL and CD4 count< or =50 (n = 5). Even patients with low initial CD4 had a significant percentage increase in CD4 count (p <.0002, r = 0.7880). CD38% showed a positive correlation with change in viral load (p =.046, r = 0.522). CONCLUSION:All patients experienced a mean viral load decrease of >2 logs (88% less than 400 copies/mL and 35% less than 20 copies/mL). There were no observed increases in liver enzymes. Patients with low CD4 counts, high initial viral load, or high CD38 expression still experienced a significant change in viral load.

journal_name

HIV Clin Trials

journal_title

HIV clinical trials

authors

Corales RB,Shrestha NK,Taege AJ,Isada CM,Rehm SJ,Schmitt SK,Gordon SM,Mawhorter SD

doi

10.1310/2V0B-HDWC-AGWR-H56M

keywords:

subject

Has Abstract

pub_date

2001-01-01 00:00:00

pages

17-21

issue

1

eissn

1528-4336

issn

1945-5771

journal_volume

2

pub_type

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    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1310/N34A-653T-ABF5-8Q1R

    authors: Levett PN,Hirschman SZ,Roach TC,Broome H,Alexander RJ,Fraser HS

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  • Rilpivirine versus efavirenz in HIV-1-infected subjects receiving emtricitabine/tenofovir DF: pooled 96-week data from ECHO and THRIVE Studies.

    abstract:OBJECTIVES:Week 96 efficacy and safety of the non-nucleoside reverse transcriptase inhibitor (NNRTI) rilpivirine (RPV) was compared to efavirenz (EFV) in subset of 1,096 subjects who received emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) in pooled data from 2 phase 3 studies. METHODS:ECHO and THRIVE are double...

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    pub_type: 杂志文章,随机对照试验

    doi:10.1310/hct1403-81

    authors: Nelson MR,Elion RA,Cohen CJ,Mills A,Hodder SL,Segal-Maurer S,Bloch M,Garner W,Guyer B,Williams S,Chuck S,Vanveggel S,Deckx H,Stevens M

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