Impact of body weight on virological and immunological responses to efavirenz-containing regimens in HIV-infected, treatment-naive adults
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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Impact of body weight on virological and immunological responses to efavirenz-containing regimens in HIV-infected, treatment-naive adults. / Marzolini, Catia; Sabin, Caroline; Raffi, François; Siccardi, Marco; Mussini, Cristina; Launay, Odile; Burger, David; Roca, Bernardino; Fehr, Jan; Bonora, Stefano; Mocroft, Amanda; Obel, Niels; Dauchy, Frederic-Antoine; Zangerle, Robert; Gogos, Charalambos; Gianotti, Nicola; Ammassari, Adriana; Torti, Carlo; Ghosn, Jade; Chêne, Genevieve; Grarup, Jesper; Battegay, Manuel; Efavirenz, Obesity Project Team on behalf of Collaboration of Observational HIV Epidemiological Research Europe (COHERE) in EuroCoord.
I: AIDS (London, England), Bind 29, Nr. 2, 01.2015, s. 193-200.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Impact of body weight on virological and immunological responses to efavirenz-containing regimens in HIV-infected, treatment-naive adults
AU - Marzolini, Catia
AU - Sabin, Caroline
AU - Raffi, François
AU - Siccardi, Marco
AU - Mussini, Cristina
AU - Launay, Odile
AU - Burger, David
AU - Roca, Bernardino
AU - Fehr, Jan
AU - Bonora, Stefano
AU - Mocroft, Amanda
AU - Obel, Niels
AU - Dauchy, Frederic-Antoine
AU - Zangerle, Robert
AU - Gogos, Charalambos
AU - Gianotti, Nicola
AU - Ammassari, Adriana
AU - Torti, Carlo
AU - Ghosn, Jade
AU - Chêne, Genevieve
AU - Grarup, Jesper
AU - Battegay, Manuel
AU - Efavirenz, Obesity Project Team on behalf of Collaboration of Observational HIV Epidemiological Research Europe (COHERE) in EuroCoord
PY - 2015/1
Y1 - 2015/1
N2 - OBJECTIVE: The prevalence of overweight and obesity is increasing among HIV-infected patients. Whether standard antiretroviral drug dosage is adequate in heavy individuals remains unresolved. We assessed the virological and immunological responses to initial efavirenz (EFV)-containing regimens in heavy compared to normal-weight HIV-infected patients.DESIGN: Observational European cohort collaboration study.METHODS: Eligible patients were antiretroviral-naïve with documented weight prior to EFV start and follow-up viral loads after treatment initiation. Cox regression analyses evaluated the association between weight and time to first undetectable viral load (<50 copies/ml) after treatment initiation, and time to viral load rebound (two consecutive viral load >50 copies/ml) after initial suppression over 5 years of follow-up. Recovery of CD4 cell count was evaluated 6 and 12 months after EFV initiation. Analyses were stratified by weight (kg) group (I - <55; II - >55, <80 (reference); III - >80, <85; IV - >85, <90; V - >90, <95; VI - >95).RESULTS: The study included 19,968 patients, of whom 9.1, 68.3, 9.1, 5.8, 3.5, and 4.3% were in weight groups I-VI, respectively. Overall, 81.1% patients attained virological suppression, of whom 34.1% subsequently experienced viral load rebound. After multiple adjustments, no statistical difference was observed in time to undetectable viral load and virological rebound for heavier individuals compared to their normal-weight counterparts. Although heaviest individuals had significantly higher CD4 cell count at baseline, CD4 cell recovery at 6 and 12 months after EFV initiation was comparable to normal-weight individuals.CONCLUSION: Virological and immunological responses to initial EFV-containing regimens were not impaired in heavy individuals, suggesting that the standard 600 mg EFV dosage is appropriate across a wide weight range.
AB - OBJECTIVE: The prevalence of overweight and obesity is increasing among HIV-infected patients. Whether standard antiretroviral drug dosage is adequate in heavy individuals remains unresolved. We assessed the virological and immunological responses to initial efavirenz (EFV)-containing regimens in heavy compared to normal-weight HIV-infected patients.DESIGN: Observational European cohort collaboration study.METHODS: Eligible patients were antiretroviral-naïve with documented weight prior to EFV start and follow-up viral loads after treatment initiation. Cox regression analyses evaluated the association between weight and time to first undetectable viral load (<50 copies/ml) after treatment initiation, and time to viral load rebound (two consecutive viral load >50 copies/ml) after initial suppression over 5 years of follow-up. Recovery of CD4 cell count was evaluated 6 and 12 months after EFV initiation. Analyses were stratified by weight (kg) group (I - <55; II - >55, <80 (reference); III - >80, <85; IV - >85, <90; V - >90, <95; VI - >95).RESULTS: The study included 19,968 patients, of whom 9.1, 68.3, 9.1, 5.8, 3.5, and 4.3% were in weight groups I-VI, respectively. Overall, 81.1% patients attained virological suppression, of whom 34.1% subsequently experienced viral load rebound. After multiple adjustments, no statistical difference was observed in time to undetectable viral load and virological rebound for heavier individuals compared to their normal-weight counterparts. Although heaviest individuals had significantly higher CD4 cell count at baseline, CD4 cell recovery at 6 and 12 months after EFV initiation was comparable to normal-weight individuals.CONCLUSION: Virological and immunological responses to initial EFV-containing regimens were not impaired in heavy individuals, suggesting that the standard 600 mg EFV dosage is appropriate across a wide weight range.
KW - Adult
KW - Antiretroviral Therapy, Highly Active
KW - Benzoxazines
KW - Body Weight
KW - CD4 Lymphocyte Count
KW - Cohort Studies
KW - Female
KW - HIV Infections
KW - Humans
KW - Male
KW - Middle Aged
KW - Obesity
KW - Regression Analysis
KW - Reverse Transcriptase Inhibitors
KW - Treatment Outcome
KW - Viral Load
U2 - 10.1097/QAD.0000000000000530
DO - 10.1097/QAD.0000000000000530
M3 - Journal article
C2 - 25426810
VL - 29
SP - 193
EP - 200
JO - AIDS
JF - AIDS
SN - 1350-2840
IS - 2
ER -
ID: 156089404