TY - JOUR
T1 - Immunovirological response to triple nucleotide reverse-transcriptase inhibitors and ritonavir-boosted protease inhibitors in treatment-naive HIV-2-infected patients: The ACHIEV2E Collaboration Study Group
AU - Benard, Antoine
AU - van Sighem, Ard
AU - Taieb, Audrey
AU - Valadas, Emilia
AU - Ruelle, Jean
AU - Soriano, Vicente
AU - Calmy, Alexandra
AU - Balotta, Claudia
AU - Damond, Florence
AU - Brun-Vezinet, Françoise
AU - Chene, Geneviève
AU - Matheron, Sophie
AU - AUTHOR GROUP
AU - Tubiana, Roland
AU - Meyohas, Marie-Caroline
AU - Bernasconi, Cornélia
AU - Dupin, Nicolas
AU - Slama, Laurence
AU - Ponscarme, Diane
AU - Lascoux-Combe, Caroline
AU - Timsit, Françoise-Julie
AU - Khuong, Marie-Aude
AU - Rami, Agathe
AU - Teichner, Elina
AU - Semaille, Caroline
AU - Quertainmont, Yann
AU - Bloch, Martine
AU - Froguel, Eric
AU - Genet, Philippe
AU - Leprêtre, Annie
AU - Zucman, David
AU - Karmochkine, Marina
AU - Blum, Laurent
AU - Chevojon, Pierre
AU - Gras, L. A. J.
AU - Prins, J. M.
AU - Kuijpers, T. W.
AU - Scherpbier, H. J.
AU - Boer, K.
AU - van der Meer, J. T. M.
AU - Wit, F. W. M. N.
AU - Godfried, M. H.
AU - Reiss, P.
AU - van der Poll, T.
AU - Nellen, F. J. B.
AU - Lange, J. M. A.
AU - Geerlings, S. E.
AU - van Vugt, M.
AU - Pajkrt, D.
AU - Bos, J. C.
AU - van der Valk, M.
PY - 2011
Y1 - 2011
N2 - Triple nucleoside reverse-transcriptase inhibitors (NRTIs) are recommended by the World Health Organization as first-line regimen in treatment-naïve HIV-2-infected patients. However, ritonavir-boosted protease inhibitor (PI/r)-containing regimens are frequently prescribed. In the absence of previous randomized trials, we retrospectively compared these regimens in observational cohorts. HIV-2-infected patients from 7 European cohorts who started triple NRTI or PI/r since January 1998 were included. Piecewise linear models were used to estimate CD4 cell count and plasma HIV-2 RNA level slopes, differentiating an early phase (until end of month 3) and a second phase (months 4-12). On-treatment analyses censored data at major treatment modification and systematically at month 12. Forty-four patients started triple NRTI therapy and 126 started PI/r therapy. Overall, the median CD4 cell count was 191 cells/mm(3) and the median plasma HIV-2 RNA level was ≥2.7 log(10) copies/ml in 61% of the patients at combination antiretroviral therapy (cART) initiation; the median duration of the first cART was 20 months, not differing between groups. PI/r regimens were associated with better CD4 cell count and HIV-2 RNA level outcomes, compared with NRTI regimens. Estimated CD4 cell count slopes were +6 and +12 cells/mm(3)/month during the early phase (P = .22), and -60 cells/mm(3)/year versus +76 cells/mm(3)/year during the second phase (P = .002), for triple NRTI and PI/r, respectively. Estimated mean HIV-2 RNA levels at month 12 in patients with detectable viremia at cART initiation were 4.0 and 2.2 log(10) copies/ml, respectively (P = .005). In this observational study, PI/r-containing regimens showed superior efficacy over triple NRTI regimens as first-line therapy in HIV-2-infected patients
AB - Triple nucleoside reverse-transcriptase inhibitors (NRTIs) are recommended by the World Health Organization as first-line regimen in treatment-naïve HIV-2-infected patients. However, ritonavir-boosted protease inhibitor (PI/r)-containing regimens are frequently prescribed. In the absence of previous randomized trials, we retrospectively compared these regimens in observational cohorts. HIV-2-infected patients from 7 European cohorts who started triple NRTI or PI/r since January 1998 were included. Piecewise linear models were used to estimate CD4 cell count and plasma HIV-2 RNA level slopes, differentiating an early phase (until end of month 3) and a second phase (months 4-12). On-treatment analyses censored data at major treatment modification and systematically at month 12. Forty-four patients started triple NRTI therapy and 126 started PI/r therapy. Overall, the median CD4 cell count was 191 cells/mm(3) and the median plasma HIV-2 RNA level was ≥2.7 log(10) copies/ml in 61% of the patients at combination antiretroviral therapy (cART) initiation; the median duration of the first cART was 20 months, not differing between groups. PI/r regimens were associated with better CD4 cell count and HIV-2 RNA level outcomes, compared with NRTI regimens. Estimated CD4 cell count slopes were +6 and +12 cells/mm(3)/month during the early phase (P = .22), and -60 cells/mm(3)/year versus +76 cells/mm(3)/year during the second phase (P = .002), for triple NRTI and PI/r, respectively. Estimated mean HIV-2 RNA levels at month 12 in patients with detectable viremia at cART initiation were 4.0 and 2.2 log(10) copies/ml, respectively (P = .005). In this observational study, PI/r-containing regimens showed superior efficacy over triple NRTI regimens as first-line therapy in HIV-2-infected patients
U2 - https://doi.org/10.1093/cid/cir123
DO - https://doi.org/10.1093/cid/cir123
M3 - Article
C2 - 21507923
SN - 1058-4838
VL - 52
SP - 1257
EP - 1266
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 10
ER -