Long-term effectiveness of recommended boosted protease inhibitor-based antiretroviral therapy in Europe
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Long-term effectiveness of recommended boosted protease inhibitor-based antiretroviral therapy in Europe. / on behalf of the EuroSIDA study group.
In: HIV Medicine, Vol. 19, No. 5, 2018, p. 324-338.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Long-term effectiveness of recommended boosted protease inhibitor-based antiretroviral therapy in Europe
AU - Santos, J. R.
AU - Cozzi-Lepri, A.
AU - Phillips, A.
AU - De Wit, S.
AU - Pedersen, C.
AU - Reiss, P.
AU - Blaxhult, A.
AU - Lazzarin, A.
AU - Sluzhynska, M.
AU - Orkin, C.
AU - Duvivier, C.
AU - Bogner, J.
AU - Gargalianos-Kakolyris, P.
AU - Schmid, P.
AU - Hassoun, G.
AU - Khromova, I.
AU - Beniowski, M.
AU - Hadziosmanovic, V.
AU - Sedlacek, D.
AU - Paredes, R.
AU - Lundgren, J. D.
AU - Losso, M.
AU - Kundro, M.
AU - Schmied, B.
AU - Zangerle, R.
AU - Karpov, I.
AU - Vassilenko, A.
AU - Mitsura, V. M.
AU - Paduto, D.
AU - Clumeck, N.
AU - Delforge, M.
AU - Florence, E.
AU - Vandekerckhove, L.
AU - Begovac, J.
AU - Machala, L.
AU - Jilich, D.
AU - Kronborg, G.
AU - Benfield, T.
AU - Gerstoft, J.
AU - Katzenstein, T.
AU - Møller, N. F.
AU - Ostergaard, L.
AU - Wiese, L.
AU - Nielsen, L. N.
AU - Zilmer, K.
AU - Smidt, J.
AU - Ristola, M.
AU - Aho, I.
AU - Kirk, O.
AU - Fischer, A. H.
AU - on behalf of the EuroSIDA study group
PY - 2018
Y1 - 2018
N2 - Objectives: The aim of the study was to evaluate the long-term response to antiretroviral treatment (ART) based on atazanavir/ritonavir (ATZ/r)-, darunavir/ritonavir (DRV/r)-, and lopinavir/ritonavir (LPV/r)-containing regimens. Methods: Data were analysed for 5678 EuroSIDA-enrolled patients starting a DRV/r-, ATZ/r- or LPV/r-containing regimen between 1 January 2000 and 30 June 2013. Separate analyses were performed for the following subgroups of patients: (1) ART-naïve subjects (8%) at ritonavir-boosted protease inhibitor (PI/r) initiation; (2) ART-experienced individuals (44%) initiating the new PI/r with a viral load (VL) ≤500 HIV-1 RNA copies/mL; and (3) ART-experienced patients (48%) initiating the new PI/r with a VL >500 copies/mL. Virological failure (VF) was defined as two consecutive VL measurements >200 copies/mL ≥24 weeks after PI/r initiation. Kaplan–Meier and multivariable Cox models were used to compare risks of failure by PI/r-based regimen. The main analysis was performed with intention-to-treat (ITT) ignoring treatment switches. Results: The time to VF favoured DRV/r over ATZ/r, and both were superior to LPV/r (log-rank test; P < 0.02) in all analyses. Nevertheless, the risk of VF in ART-naïve patients was similar regardless of the PI/r initiated after controlling for potential confounders. The risk of VF in both treatment-experienced groups was lower for DRV/r than for ATZ/r, which, in turn, was lower than for LPV/r-based ART. Conclusions: Although confounding by indication and calendar year cannot be completely ruled out, in ART-experienced subjects the long-term effectiveness of DRV/r-containing regimens appears to be greater than that of ATZ/r and LPV/r.
AB - Objectives: The aim of the study was to evaluate the long-term response to antiretroviral treatment (ART) based on atazanavir/ritonavir (ATZ/r)-, darunavir/ritonavir (DRV/r)-, and lopinavir/ritonavir (LPV/r)-containing regimens. Methods: Data were analysed for 5678 EuroSIDA-enrolled patients starting a DRV/r-, ATZ/r- or LPV/r-containing regimen between 1 January 2000 and 30 June 2013. Separate analyses were performed for the following subgroups of patients: (1) ART-naïve subjects (8%) at ritonavir-boosted protease inhibitor (PI/r) initiation; (2) ART-experienced individuals (44%) initiating the new PI/r with a viral load (VL) ≤500 HIV-1 RNA copies/mL; and (3) ART-experienced patients (48%) initiating the new PI/r with a VL >500 copies/mL. Virological failure (VF) was defined as two consecutive VL measurements >200 copies/mL ≥24 weeks after PI/r initiation. Kaplan–Meier and multivariable Cox models were used to compare risks of failure by PI/r-based regimen. The main analysis was performed with intention-to-treat (ITT) ignoring treatment switches. Results: The time to VF favoured DRV/r over ATZ/r, and both were superior to LPV/r (log-rank test; P < 0.02) in all analyses. Nevertheless, the risk of VF in ART-naïve patients was similar regardless of the PI/r initiated after controlling for potential confounders. The risk of VF in both treatment-experienced groups was lower for DRV/r than for ATZ/r, which, in turn, was lower than for LPV/r-based ART. Conclusions: Although confounding by indication and calendar year cannot be completely ruled out, in ART-experienced subjects the long-term effectiveness of DRV/r-containing regimens appears to be greater than that of ATZ/r and LPV/r.
KW - antiretroviral therapy-experienced patients
KW - antiretroviral therapy-naïve patients
KW - atazanavir/ritonavir
KW - darunavir/ritonavir
KW - lopinavir/ritonavir
U2 - 10.1111/hiv.12581
DO - 10.1111/hiv.12581
M3 - Journal article
C2 - 29388732
AN - SCOPUS:85041304540
VL - 19
SP - 324
EP - 338
JO - HIV Medicine
JF - HIV Medicine
SN - 1464-2662
IS - 5
ER -
ID: 214514817