Increased Virological Failure in Naive HIV-1-Infected Patients Taking Lamivudine Compared With Emtricitabine in Combination With Tenofovir and Efavirenz or Nevirapine in the Dutch Nationwide ATHENA Cohort

AUTHOR GROUP

doi:https://doi.org/10.1093/cid/ciu763

Increased Virological Failure in Naive HIV-1-Infected Patients Taking Lamivudine Compared With Emtricitabine in Combination With Tenofovir and Efavirenz or Nevirapine in the Dutch Nationwide ATHENA Cohort

AUTHOR GROUP

Research output: Contribution to journal › Article › Academic › peer-review

21 Citations (Scopus)

Abstract

Background. Guidelines for treatment of human immunodeficiency virus type 1 (HIV-1) infection consider lamivudine and emtricitabine to be interchangeable components in first-line combination antiretroviral therapy (cART). The evidence for their clinical equivalence in cART is inconsistent. The primary aim of this study was to evaluate the virological responses to lamivudine and emtricitabine in recommended cART. Methods. This was an observational study using data from the AIDS Therapy Evaluation in the Netherlands (ATHENA) nationwide HIV cohort. The virological responses to lamivudine and emtricitabine were compared by multivariable adjusted logistic regression and Cox proportional hazard models. Sensitivity analyses included propensity score-adjusted models. Results. Therapy-naive HIV-1-infected patients without baseline resistance (N = 4740) initiated lamivudine or emtricitabine with efavirenz/tenofovir or nevirapine/tenofovir. The use of lamivudine was associated with more virological failure at week 48 compared to emtricitabine with efavirenz/tenofovir (10.8% vs 3.6%; adjusted odds ratio [AOR], 1.78; 95% confidence interval [CI], 1.11-2.84) and nevirapine/tenofovir (27% vs 11%; AOR, 2.09; 95% CI, 1.25-3.52) in on-treatment analysis. Propensity score-adjusted models and intent-to-treat sensitivity analyses gave comparable results. The adjusted hazard ratio of virological failure at week 240 using lamivudine instead of emtricitabine was 2.35 (95% CI, 1.61-3.42) with efavirenz and 2.01 (95% CI, 1.36-2.98) with nevirapine. The inclusion of lamivudine or emtricitabine in cART did not influence the time to virological suppression within 48 weeks or the probability of virological rebound after successful virological suppression. Conclusions. The use of emtricitabine instead of lamivudine as part of cART was associated with better virological responses. These findings are relevant for settings with extensive use of lamivudine and for settings where generic lamivudine will be available

Original language	English
Pages (from-to)	143-153
Journal	Clinical Infectious Diseases
Volume	60
Issue number	1
DOIs	https://doi.org/10.1093/cid/ciu763
Publication status	Published - 2015

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https://doi.org/10.1093/cid/ciu763

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@article{157285872243443bbf64a98e06028fbd,

title = "Increased Virological Failure in Naive HIV-1-Infected Patients Taking Lamivudine Compared With Emtricitabine in Combination With Tenofovir and Efavirenz or Nevirapine in the Dutch Nationwide ATHENA Cohort",

abstract = "Background. Guidelines for treatment of human immunodeficiency virus type 1 (HIV-1) infection consider lamivudine and emtricitabine to be interchangeable components in first-line combination antiretroviral therapy (cART). The evidence for their clinical equivalence in cART is inconsistent. The primary aim of this study was to evaluate the virological responses to lamivudine and emtricitabine in recommended cART. Methods. This was an observational study using data from the AIDS Therapy Evaluation in the Netherlands (ATHENA) nationwide HIV cohort. The virological responses to lamivudine and emtricitabine were compared by multivariable adjusted logistic regression and Cox proportional hazard models. Sensitivity analyses included propensity score-adjusted models. Results. Therapy-naive HIV-1-infected patients without baseline resistance (N = 4740) initiated lamivudine or emtricitabine with efavirenz/tenofovir or nevirapine/tenofovir. The use of lamivudine was associated with more virological failure at week 48 compared to emtricitabine with efavirenz/tenofovir (10.8% vs 3.6%; adjusted odds ratio [AOR], 1.78; 95% confidence interval [CI], 1.11-2.84) and nevirapine/tenofovir (27% vs 11%; AOR, 2.09; 95% CI, 1.25-3.52) in on-treatment analysis. Propensity score-adjusted models and intent-to-treat sensitivity analyses gave comparable results. The adjusted hazard ratio of virological failure at week 240 using lamivudine instead of emtricitabine was 2.35 (95% CI, 1.61-3.42) with efavirenz and 2.01 (95% CI, 1.36-2.98) with nevirapine. The inclusion of lamivudine or emtricitabine in cART did not influence the time to virological suppression within 48 weeks or the probability of virological rebound after successful virological suppression. Conclusions. The use of emtricitabine instead of lamivudine as part of cART was associated with better virological responses. These findings are relevant for settings with extensive use of lamivudine and for settings where generic lamivudine will be available",

author = "Casper Rokx and Azzania Fibriani and {van de Vijver}, {David A. M. C.} and Annelies Verbon and Martin Schutten and Luuk Gras and Rijnders, {Bart J. A.} and {AUTHOR GROUP} and Prins, {J. M.} and Kuijpers, {T. W.} and Scherpbier, {H. J.} and {van der Meer}, {J. T. M.} and Wit, {F. W. M. N.} and Godfried, {M. H.} and P. Reiss and {van der Poll}, T. and Nellen, {F. J. B.} and Lange, {J. M. A.} and Geerlings, {S. E.} and {van Vugt}, M. and D. Pajkrt and Bos, {J. C.} and {van der Valk}, M. and Wiersinga, {W. J.} and A. Goorhuis and Hovius, {J. W. R.} and S. Lowe and {Oude Lashof}, A. and D. Posthouwer and Pronk, {J. H.} and Ammerlaan, {H. S. M.} and {van der Ende}, {M. E.} and {de Vries-Sluijs}, {T. E. M. S.} and Schurink, {C. A. M.} and Nouwen, {J. L.} and A. Verbon and Rijnders, {B. J. A.} and {van Gorp}, {E. C. M.} and {van der Feltz}, M. and Driessen, {G. J. A.} and {van Rossum}, {A. M. C.} and J. Branger and Schippers, {E. F.} and {van Nieuwkoop}, C. and {van Elzakker}, {E. P.} and Groeneveld, {P. H. P.} and Bouwhuis, {J. W.} and R. Soetekouw and {ten Kate}, {R. W.} and Kroon, {F. P.} and {van Dissel}, {J. T.}",

year = "2015",

doi = "https://doi.org/10.1093/cid/ciu763",

language = "English",

volume = "60",

pages = "143--153",

journal = "Clinical Infectious Diseases",

issn = "1058-4838",

publisher = "Oxford University Press",

number = "1",

}

Increased Virological Failure in Naive HIV-1-Infected Patients Taking Lamivudine Compared With Emtricitabine in Combination With Tenofovir and Efavirenz or Nevirapine in the Dutch Nationwide ATHENA Cohort. / AUTHOR GROUP.
In: Clinical Infectious Diseases, Vol. 60, No. 1, 2015, p. 143-153.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Increased Virological Failure in Naive HIV-1-Infected Patients Taking Lamivudine Compared With Emtricitabine in Combination With Tenofovir and Efavirenz or Nevirapine in the Dutch Nationwide ATHENA Cohort

AU - Rokx, Casper

AU - Fibriani, Azzania

AU - van de Vijver, David A. M. C.

AU - Verbon, Annelies

AU - Schutten, Martin

AU - Gras, Luuk

AU - Rijnders, Bart J. A.

AU - AUTHOR GROUP

AU - Prins, J. M.

AU - Kuijpers, T. W.

AU - Scherpbier, H. J.

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.

AU - Wiersinga, W. J.

AU - Goorhuis, A.

AU - Hovius, J. W. R.

AU - Lowe, S.

AU - Oude Lashof, A.

AU - Posthouwer, D.

AU - Pronk, J. H.

AU - Ammerlaan, H. S. M.

AU - van der Ende, M. E.

AU - de Vries-Sluijs, T. E. M. S.

AU - Schurink, C. A. M.

AU - Nouwen, J. L.

AU - Verbon, A.

AU - Rijnders, B. J. A.

AU - van Gorp, E. C. M.

AU - van der Feltz, M.

AU - Driessen, G. J. A.

AU - van Rossum, A. M. C.

AU - Branger, J.

AU - Schippers, E. F.

AU - van Nieuwkoop, C.

AU - van Elzakker, E. P.

AU - Groeneveld, P. H. P.

AU - Bouwhuis, J. W.

AU - Soetekouw, R.

AU - ten Kate, R. W.

AU - Kroon, F. P.

AU - van Dissel, J. T.

PY - 2015

Y1 - 2015

N2 - Background. Guidelines for treatment of human immunodeficiency virus type 1 (HIV-1) infection consider lamivudine and emtricitabine to be interchangeable components in first-line combination antiretroviral therapy (cART). The evidence for their clinical equivalence in cART is inconsistent. The primary aim of this study was to evaluate the virological responses to lamivudine and emtricitabine in recommended cART. Methods. This was an observational study using data from the AIDS Therapy Evaluation in the Netherlands (ATHENA) nationwide HIV cohort. The virological responses to lamivudine and emtricitabine were compared by multivariable adjusted logistic regression and Cox proportional hazard models. Sensitivity analyses included propensity score-adjusted models. Results. Therapy-naive HIV-1-infected patients without baseline resistance (N = 4740) initiated lamivudine or emtricitabine with efavirenz/tenofovir or nevirapine/tenofovir. The use of lamivudine was associated with more virological failure at week 48 compared to emtricitabine with efavirenz/tenofovir (10.8% vs 3.6%; adjusted odds ratio [AOR], 1.78; 95% confidence interval [CI], 1.11-2.84) and nevirapine/tenofovir (27% vs 11%; AOR, 2.09; 95% CI, 1.25-3.52) in on-treatment analysis. Propensity score-adjusted models and intent-to-treat sensitivity analyses gave comparable results. The adjusted hazard ratio of virological failure at week 240 using lamivudine instead of emtricitabine was 2.35 (95% CI, 1.61-3.42) with efavirenz and 2.01 (95% CI, 1.36-2.98) with nevirapine. The inclusion of lamivudine or emtricitabine in cART did not influence the time to virological suppression within 48 weeks or the probability of virological rebound after successful virological suppression. Conclusions. The use of emtricitabine instead of lamivudine as part of cART was associated with better virological responses. These findings are relevant for settings with extensive use of lamivudine and for settings where generic lamivudine will be available

AB - Background. Guidelines for treatment of human immunodeficiency virus type 1 (HIV-1) infection consider lamivudine and emtricitabine to be interchangeable components in first-line combination antiretroviral therapy (cART). The evidence for their clinical equivalence in cART is inconsistent. The primary aim of this study was to evaluate the virological responses to lamivudine and emtricitabine in recommended cART. Methods. This was an observational study using data from the AIDS Therapy Evaluation in the Netherlands (ATHENA) nationwide HIV cohort. The virological responses to lamivudine and emtricitabine were compared by multivariable adjusted logistic regression and Cox proportional hazard models. Sensitivity analyses included propensity score-adjusted models. Results. Therapy-naive HIV-1-infected patients without baseline resistance (N = 4740) initiated lamivudine or emtricitabine with efavirenz/tenofovir or nevirapine/tenofovir. The use of lamivudine was associated with more virological failure at week 48 compared to emtricitabine with efavirenz/tenofovir (10.8% vs 3.6%; adjusted odds ratio [AOR], 1.78; 95% confidence interval [CI], 1.11-2.84) and nevirapine/tenofovir (27% vs 11%; AOR, 2.09; 95% CI, 1.25-3.52) in on-treatment analysis. Propensity score-adjusted models and intent-to-treat sensitivity analyses gave comparable results. The adjusted hazard ratio of virological failure at week 240 using lamivudine instead of emtricitabine was 2.35 (95% CI, 1.61-3.42) with efavirenz and 2.01 (95% CI, 1.36-2.98) with nevirapine. The inclusion of lamivudine or emtricitabine in cART did not influence the time to virological suppression within 48 weeks or the probability of virological rebound after successful virological suppression. Conclusions. The use of emtricitabine instead of lamivudine as part of cART was associated with better virological responses. These findings are relevant for settings with extensive use of lamivudine and for settings where generic lamivudine will be available

U2 - https://doi.org/10.1093/cid/ciu763

DO - https://doi.org/10.1093/cid/ciu763

M3 - Article

C2 - 25273080

SN - 1058-4838

VL - 60

SP - 143

EP - 153

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

IS - 1

ER -