Long‐term effectiveness of recommended boosted protease inhibitor‐based antiretroviral therapy in Europe. Issue 5 (1st February 2018)

• Record Type: Journal Article
• Authors: Santos, JR; Cozzi‐Lepri, A; Phillips, A; De Wit, S; Pedersen, C; Reiss, P; Blaxhult, A; Lazzarin, A; Sluzhynska, M; Orkin, C; Duvivier, C; Bogner, J; Gargalianos‐Kakolyris, P; Schmid, P; Hassoun, G; Khromova, I; Beniowski, M; Hadziosmanovic, V; Sedlacek, D; Paredes, R; Lundgren, JD
• Other Names: Losso M investigator.; Kundro M investigator.; Schmied B investigator.; Zangerle R investigator.; Karpov I investigator.; Vassilenko A investigator.; Mitsura V. M investigator.; Paduto D investigator.; Clumeck N investigator.; Delforge M investigator.; Florence E investigator.; Vandekerckhove L investigator.; Begovac J investigator.; Machala L investigator.; Jilich D investigator.; Kronborg G investigator.; Benfield T investigator.; Gerstoft J investigator.; Katzenstein T investigator.; Møller N. F investigator.; Ostergaard L investigator.; Wiese L investigator.; Nielsen L. N investigator.; Zilmer K investigator.; Smidt J investigator.; Ristola M investigator.; Aho I investigator.; Viard J.‐P investigator.; Girard P.‐M investigator.; Pradier C investigator.; Fontas E investigator.; Rockstroh J investigator.; Schmidt R investigator.; Degen O investigator.; Stellbrink H. J investigator.; Stefan C investigator.; Fätkenheuer G investigator.; Chkhartishvili N investigator.; Gargalianos P investigator.; Xylomenos G investigator.; Lourida P investigator.; Sambatakou H investigator.; Szlávik J investigator.; Gottfredsson M investigator.; Mulcahy F investigator.; Yust I investigator.; Turner D investigator.; Burke M investigator.; Shahar E investigator.; Elinav H investigator.; Haouzi M investigator.; Elbirt D investigator.; Sthoeger Z. M investigator.; D'Arminio Monforte A investigator.; Esposito R investigator.; Mazeu I investigator.; Mussini C investigator.; Mazzotta F investigator.; Gabbuti A investigator.; Vullo V investigator.; Lichtner M investigator.; Zaccarelli M investigator.; Antinori A investigator.; Acinapura R investigator.; Plazzi M investigator.; Castagna A investigator.; Gianotti N investigator.; Galli M investigator.; Ridolfo A investigator.; Rozentale B investigator.; Uzdaviniene V investigator.; Matulionyte R investigator.; Staub T investigator.; Hemmer R investigator.; Ormaasen V investigator.; Maeland A investigator.; Bruun J investigator.; Knysz B investigator.; Gasiorowski J investigator.; Inglot M investigator.; Horban A investigator.; Bakowska E investigator.; Flisiak R investigator.; Grzeszczuk A investigator.; Parczewski M investigator.; Pynka M investigator.; Maciejewska K investigator.; Mularska E investigator.; Smiatacz T investigator.; Gensing M investigator.; Jablonowska E investigator.; Malolepsza E investigator.; Wojcik K investigator.; Mozer‐Lisewska I investigator.; Caldeira L investigator.; Mansinho K investigator.; Maltez F investigator.; Radoi R investigator.; Panteleev A investigator.; Panteleev O investigator.; Yakovlev A investigator.; Trofimora T investigator.; Kuzovatova E investigator.; Borodulina E investigator.; Vdoushkina E investigator.; Jevtovic D investigator.; Tomazic J investigator.; Gatell J. M investigator.; Miró J. M investigator.; Moreno S investigator.; Rodriguez J. M investigator.; Clotet B investigator.; Jou A investigator.; Tural C investigator.; Puig J investigator.; Bravo I investigator.; Domingo P investigator.; Gutierrez M investigator.; Mateo G investigator.; Sambeat M. A investigator.; Laporte J. M investigator.; Falconer K investigator.; Thalme A investigator.; Sonnerborg A investigator.; Flamholc L investigator.; Scherrer A investigator.; Weber R investigator.; Cavassini M investigator.; Calmy A investigator.; Furrer H investigator.; Battegay M investigator.; Kuznetsova A investigator.; Kyselyova G investigator.; Gazzard B investigator.; Johnson A. M investigator.; Simons E investigator.; Edwards S investigator.; Johnson M. A investigator.; Mocroft A investigator.; Weber J investigator.; Scullard G investigator.; Clarke A investigator.; Leen C investigator.; Gatell J investigator.; Ledergerber B investigator.; Lundgren J investigator.; Kirk O investigator.; Peters L investigator.; Matthews C investigator.; Fischer A. H investigator.; Bojesen A investigator.; Raben D investigator.; Kristensen D investigator.; Grønborg Laut K investigator.; Larsen J. F investigator.; Podlekareva D investigator.; Shepherd L investigator.; Schultze A investigator.; Thiebaut R investigator.; Burger D investigator.;
• Is Part Of: HIV medicine. Volume 19:Issue 5(2018)
• Page Start: 324
• Page End: 338
• Publication Date: 2018-02-01
• Subjects: antiretroviral therapy‐experienced patients -- antiretroviral therapy‐naïve patients -- atazanavir/ritonavir -- darunavir/ritonavir -- lopinavir/ritonavir; HIV infections -- Treatment -- Periodicals; HIV-positive persons -- Periodicals; HIV infections -- Treatment -- Decision making -- Periodicals; 616.9792
• DOI: 10.1111/hiv.12581
• Languages: English
• ISSNs: 1464-2662

Abstract

Abstract : 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.