Time to treatment disruption in children with HIV-1 randomized to initial antiretroviral therapy with protease inhibitors versus non-nucleoside reverse transcriptase inhibitors
| Autor: | Stephen R. Cole, Meredith G. Warshaw, Penpact (Penta ), Christina Ludema, Pactg Study Team, Carol E. Golin, Ross E. McKinney, Dwight E. Yin, William C. Miller |
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| Rok vydání: | 2020 |
| Předmět: |
Oncology
Male Questionnaires medicine.medical_treatment HIV Infections Kaplan-Meier Estimate Biochemistry Pediatrics Nucleoside Reverse Transcriptase Inhibitor CRIANÇAS Antiretroviral Therapy Highly Active HIV Seropositivity Medicine and Health Sciences Public and Occupational Health Enzyme Inhibitors Child Multidisciplinary Protease Inhibitor Therapy Reverse-transcriptase inhibitor Pharmaceutics Antimicrobials Hazard ratio Drugs Viral Load Antivirals Vaccination and Immunization Tolerability Research Design Child Preschool Medicine Reverse Transcriptase Inhibitors Female medicine.drug Research Article medicine.medical_specialty Drug Adherence Adolescent Anti-HIV Agents Science Immunology Antiretroviral Therapy Research and Analysis Methods Microbiology Time-to-Treatment Antiviral Therapy Drug Therapy Internal medicine Microbial Control Virology medicine Humans Protease inhibitor (pharmacology) Protease Inhibitors Proportional Hazards Models Pharmacology Protease Survey Research business.industry Proportional hazards model Infant Biology and Life Sciences HIV Protease Inhibitors CD4 Lymphocyte Count Regimen HIV-1 Enzymology Patient Compliance Preventive Medicine business |
| Zdroj: | PLoS ONE Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual) Universidade de São Paulo (USP) instacron:USP PLoS ONE, Vol 15, Iss 11, p e0242405 (2020) |
| ISSN: | 1932-6203 |
| Popis: | Background Choice of initial antiretroviral therapy regimen may help children with HIV maintain optimal, continuous therapy. We assessed treatment-naïve children for differences in time to treatment disruption across randomly-assigned protease inhibitor versus non-nucleoside reverse transcriptase inhibitor-based initial antiretroviral therapy. Methods We performed a secondary analysis of a multicenter phase 2/3, randomized, open-label trial in Europe, North and South America from 2002 to 2009. Children aged 31 days to Results The modified intention-to-treat analysis included 263 participants. Seventy-two percent (n = 190) of participants experienced at least one treatment disruption during study. At 4 years, treatment disruption probabilities were 70% (protease inhibitor) vs. 63% (non-nucleoside reverse transcriptase inhibitor). The unadjusted hazard ratio (HR) for treatment disruptions comparing protease inhibitor vs. non-nucleoside reverse transcriptase inhibitor-based regimens was 1.19, 95% confidence interval [CI] 0.88–1.61 (adjusted HR 1.24, 95% CI 0.91–1.68). By study end, treatment disruption probabilities converged (protease inhibitor 81%, non-nucleoside reverse transcriptase inhibitor 84%) with unadjusted HR 1.11, 95% CI 0.84–1.48 (adjusted HR 1.13, 95% CI 0.84–1.50). Reported reasons for treatment disruptions suggested that participants on protease inhibitors experienced greater tolerability problems. Conclusions Children had similar time to treatment disruption for initial protease inhibitor and non-nucleoside reverse transcriptase inhibitor-based antiretroviral therapy, despite greater reported tolerability problems with protease inhibitor regimens. Initial pediatric antiretroviral therapy with either a protease inhibitor or non-nucleoside reverse transcriptase inhibitor may be acceptable for maintaining optimal, continuous therapy. |
| Databáze: | OpenAIRE |
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