Simplification to dual-therapy containing lamivudine and darunavir/ritonavir or atazanavir/ritonavir in HIV-infected patients on virologically suppressive antiretroviral therapy.

Autor: Calza L; a S. Orsola-Malpighi Hospital , Clinic of Infectious Diseases, 'Alma Mater Studiorum' University of Bologna , Bologna , Italy., Cafaggi M; a S. Orsola-Malpighi Hospital , Clinic of Infectious Diseases, 'Alma Mater Studiorum' University of Bologna , Bologna , Italy., Colangeli V; a S. Orsola-Malpighi Hospital , Clinic of Infectious Diseases, 'Alma Mater Studiorum' University of Bologna , Bologna , Italy., Borderi M; a S. Orsola-Malpighi Hospital , Clinic of Infectious Diseases, 'Alma Mater Studiorum' University of Bologna , Bologna , Italy., Barchi E; b Infectious Diseases Unit, S. Maria Nuova Hospital , Reggio Emilia , Italy., Lanzafame M; c Infectious Diseases Unit, G.B. Rossi University Hospital , Verona , Italy., Nicole' S; c Infectious Diseases Unit, G.B. Rossi University Hospital , Verona , Italy., Degli Antoni AM; d Infectious Diseases and Hepatology Unit, Maggiore University Hospital , Parma , Italy., Bon I; e Unit of Microbiology, 'Alma Mater Studiorum' University of Bologna, S. Orsola-Malpighi Hospital , Bologna , Italy., Re MC; e Unit of Microbiology, 'Alma Mater Studiorum' University of Bologna, S. Orsola-Malpighi Hospital , Bologna , Italy., Viale P; a S. Orsola-Malpighi Hospital , Clinic of Infectious Diseases, 'Alma Mater Studiorum' University of Bologna , Bologna , Italy.
Jazyk: angličtina
Zdroj: Infectious diseases (London, England) [Infect Dis (Lond)] 2018 May; Vol. 50 (5), pp. 352-360. Date of Electronic Publication: 2017 Dec 06.
DOI: 10.1080/23744235.2017.1410285
Abstrakt: Background: The ritonavir-boosted protease inhibitor (PI/r)-based dual regimens are warranted in order to optimize the combination antiretroviral therapy (cART), prevent the long-term toxicity and reduce the cost of treatments.
Methods: We performed an observational, retrospective study of HIV-infected patients on suppressive antiretroviral therapy who switched to a dual regimen containing lamivudine (3TC) plus darunavir/ritonavir (DRV/r) 800/100 mg qd or atazanavir/ritonavir (ATV/r) 300/100 mg qd.
Results: As a whole, 122 well-treated patients (mean age, 45.2 years; mean CD4 T + lymphocyte count, 589 cells/mm 3 ; mean duration of current cART, 3.1 years) were enrolled. Current antiretroviral regimen included tenofovir/emtricitabine in 91 subjects, abacavir/lamivudine in 25, lopinavir/r in 41, DRV/r in 38 and ATV/r in 33. Baseline mean estimated glomerular filtration rate (eGFR) was 94.2 mL/min/1.73 m 2 , and proteinuria was detected in 46 subjects (38%). Overall 70 subjects switched to 3TC + DRV/r (group A) and 52 to 3TC + ATV/r (group B). After 12 months, 65 patients (92.8%) in group A and 46 (88.4%) in group B showed HIV RNA <20 copies/mL. A significant and comparable increase in eGFR was observed in group A and B (+3.8 and +3.1 mL/min/1.73 m 2 , respectively), such as a significant decrease in prevalence of proteinuria. A significantly greater increase in total bilirubin concentration was reported in group B than in group A.
Conclusion: In our study, simplification to a dual therapy containing 3TC + DRV/r or ATV/r in virologically suppressed patients was effective and showed a good tolerability profile.
Databáze: MEDLINE
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