TY - JOUR
T1 - Alternative multidrug regimen provides improved suppression of HIV-1 replication over triple therapy
AU - Weverling, Gerrit J.
AU - Lange, Joep M.A.
AU - Jurriaans, Suzanne
AU - Prins, Jan M.
AU - Lukashov, Vladimir V.
AU - Notermans, Daan W.
AU - Roos, Marijke
AU - Schuitemaker, Hanneke
AU - Hoetelmans, Richard M.W.
AU - Danner, Sven A.
AU - Goudsmit, Jaap
AU - De Wolf, Frank
PY - 1998/7/30
Y1 - 1998/7/30
N2 - Objective: To compare the viral suppression of two antiretroviral regimens using three drugs or five drugs. Design: Two open-label studies using a three-drug (zidovudine, lamivudine and ritonavir) and a five-drug regimen (zidovudine, lamivudine, abacavir, indinavir and nevirapine) in study-drug-naive patients, except for one in the five-drug study. Methods: Participants with ≤ 10,000 HIV-1 RNA copies/ml in plasma at baseline were compared by means of Kaplan-Meier curves for time to < 50 copies/ml, as well as linear regression analysis for the first phase of decline using log-transformed copy numbers. Results: The elimination rate constants For HIV-1 RNA in 15 participants of the three-drug study were compared with nine participants of the five-drug study. The level of < 50 copies/ml was reached earlier when using the five-drug than when using the three-drug regimen (P log rank = 0.0005): median time to reach this level was 4 weeks and 12 weeks, respectively. No differences were found in HIV-1 RNA elimination rate constants in the first 2 weeks after the initiation of therapy. When the viral load declines were calculated from day 2 onwards, adjusting for differences in pharmacological delay of the drugs used, again no differences in early viral load decline were found between the two regimens. Conclusion: With the five drugs used in this study, the median time to reach < 50 HIV-1 RNA copies/ml was 8 weeks shorter than with the three-drug regimen. This finding shows that suppression of viral load in HIV-infection by standard triple-drug therapy can be improved upon.
AB - Objective: To compare the viral suppression of two antiretroviral regimens using three drugs or five drugs. Design: Two open-label studies using a three-drug (zidovudine, lamivudine and ritonavir) and a five-drug regimen (zidovudine, lamivudine, abacavir, indinavir and nevirapine) in study-drug-naive patients, except for one in the five-drug study. Methods: Participants with ≤ 10,000 HIV-1 RNA copies/ml in plasma at baseline were compared by means of Kaplan-Meier curves for time to < 50 copies/ml, as well as linear regression analysis for the first phase of decline using log-transformed copy numbers. Results: The elimination rate constants For HIV-1 RNA in 15 participants of the three-drug study were compared with nine participants of the five-drug study. The level of < 50 copies/ml was reached earlier when using the five-drug than when using the three-drug regimen (P log rank = 0.0005): median time to reach this level was 4 weeks and 12 weeks, respectively. No differences were found in HIV-1 RNA elimination rate constants in the first 2 weeks after the initiation of therapy. When the viral load declines were calculated from day 2 onwards, adjusting for differences in pharmacological delay of the drugs used, again no differences in early viral load decline were found between the two regimens. Conclusion: With the five drugs used in this study, the median time to reach < 50 HIV-1 RNA copies/ml was 8 weeks shorter than with the three-drug regimen. This finding shows that suppression of viral load in HIV-infection by standard triple-drug therapy can be improved upon.
KW - Antiretroviral therapy
KW - HIV-1 RNA elimination rate constants
KW - HIV-1 RNA suppression
KW - Multidrug therapy
UR - http://www.scopus.com/inward/record.url?scp=15144339718&partnerID=8YFLogxK
U2 - https://doi.org/10.1097/00002030-199811000-00003
DO - https://doi.org/10.1097/00002030-199811000-00003
M3 - Article
C2 - 9708401
SN - 0269-9370
VL - 12
SP - F117-F122
JO - AIDS
JF - AIDS
IS - 11
ER -