| Autor: |
Antonella d'Arminio Monforte, Alessandro, Cozzi-Lepri, DI BIAGIO, Antonio, Giulia, Marchetti, Sergio Lo Caputo, Stefano, Rusconi, Nicola, Gianotti, Valentina, Mazzotta, Giovanni, Mazzarello, Andrea, Costantini, Antonella, Castagna, Andrea, Antinori, A d'Arminio Monforte, Antinori, A, Andreoni, M, Castagna, A, Castelli, F, Cauda, R, G Di Perri, Galli, M, Iardino, R, Ippolito, G, Lazzarin, A, C Marchetti, G, Rezza, G, F von Schloesser, Viale, P, Ceccherini-Silberstein, F, Cozzi-Lepri, A, Girardi, E, S Lo Caputo, Mussini, C, Puoti, M, F Perno, C, Balotta, C, Bandera, A, Bonora, S, Borderi, M, Calcagno, A, Capetti, A, R Capobianchi, M, Cicalini, S, Cingolani, A, Cinque, P, A De Luca, A Di Biagio, Gianotti, N, Gori, A, Guaraldi, G, Lapadula, G, Lichtner, M, Madeddu, G, Maggiolo, F, Marchetti, G, Monno, L, Nozza, S, Pinnetti, C, E Quiros Roldan, Rossotti, R, Rusconi, S, M Santoro, M, Saracino, A, Sarmati, L, Fanti, I, Galli, L, Lorenzini, P, Rodan(`(o))', A, Macchia, M, Tavelli, A, Carletti, F, Carrara, S, A Di Caro, Graziano, S, Petrone, F, Prota, G, Quartu, S, Truffa, S, Giacometti, A, Costantini, A, Barocci, V, Angarano, G, Fabrizio, C, Suardi, C, Donati, V, Verucchi, G, Castelnuovo, F, Minardi, C, Menzaghi, B, Abeli, C, Cacopardo, B, Celesia, B, Vecchiet, J, Falasca, K, Pan, A, Lorenzotti, S, Sighinolfi, L, Segala, D, Blanc, P, Vichi, F, Cassola, G, Viscoli, C, Alessandrini, A, Bobbio, N, Mazzarello, G, Pozzetto, I, Bonfanti, P, Molteni, C, Chiodera, A, Milini, P, Nunnari, G, Pellican(`(o)), G, Rizzardini, G, Bai, F, C Moioli, M, Piolini, R, L Ridolfo, A, Salpietro, S, Tincati, C, Puzzolante, C, Migliorino, C, Sangiovanni, V, Borgia, G, Esposito, V, F Di Martino, Gentile, I, Maddaloni, L, M Cattelan, A, Marinello, S, Cascio, A, Colomba, C, Baldelli, F, Schiaroli, E, Parruti, G, Sozio, F, Magnani, G, A Ursitti, M, Cristaudo, A, Vullo, V, Acinapura, R, Baldin, G, Capozzi, M, Mondi, A, M Rivano Capparucia, Iaiani, G, Latini, A, Gagliardini, R, M Plazzi, M, Savinelli, S, Vergori, A, Cecchetto, M, Viviani, F, Bagella, P, Rossetti, B, Franco, A, R Fontana Del Vecchio, Francisci, D, C Di Giuli, Caramello, P, C Orofino, G, Sciandra, M, Bassetti, M, Londero, A, Pellizzer, G, Manfrin, V, Starnini, G, A Ialungo and |
| Přispěvatelé: |
d'Arminio Monforte, Antonella, Cozzi-Lepri, Alessandro, Di Biagio, Antonio, Marchetti, Giulia, Lo Caputo, Sergio, Rusconi, Stefano, Gianotti, Nicola, Mazzotta, Valentina, Mazzarello, Giovanni, Costantini, Andrea, Castagna, Antonella, Antinori, Andrea |
| Rok vydání: |
2018 |
| Předmět: |
|
| Zdroj: |
The Journal of antimicrobial chemotherapy. 74(5) |
| ISSN: |
1460-2091 |
| Popis: |
Objectives To evaluate the durability of three integrase strand transfer inhibitors (INSTIs) and two NRTIs in ART-naive individuals. Methods The study design was observational. Patients were HIV-positive, ART-naive subjects starting raltegravir, elvitegravir/cobicistat or dolutegravir with two NRTIs. The primary endpoint was time to treatment failure, i.e. occurrence of virological failure (first of two consecutive plasma HIV RNAs ≥200 copies/mL after 24 weeks) or INSTI discontinuation for any reason apart from simplification. Secondary endpoints were INSTI discontinuation due to toxicity/intolerance and CD4 count response. Survival analysis was done using Kaplan-Meier and Cox regression. Results Two thousand and sixteen patients were included: 310 (15.4%) started raltegravir-based regimens, 994 (49.3%) started dolutegravir-based regimens and 712 (35.3%) started elvitegravir/cobicistat-based regimens. Over a median of 11 months, 167 patients experienced treatment failure; the 1 year probability of treatment failure was 6.5% for raltegravir, 5.4% for dolutegravir and 6.7% for elvitegravir/cobicistat (P = 0.001). Sixty-eight patients (3.4%) discontinued INSTIs owing to toxicity/intolerance. By multivariable analysis, patients starting raltegravir had a 2.03-fold (95% CI = 1.2-3.2) higher risk and patients on elvitegravir/cobicistat a 1.88-fold (95% CI = 1.2-2.9) higher risk of treatment failure versus dolutegravir; there was no difference in risk of discontinuation due to toxicity/intolerance when comparing dolutegravir and raltegravir and marginal evidence for a difference when comparing elvitegravir/cobicistat and dolutegravir (adjusted relative hazard = 1.94 for elvitegravir/cobicistat versus dolutegravir, 95% CI = 1.00-3.76, P = 0.05). Conclusions In our real-life setting, INSTI-based regimens showed high potency and durability. Among regimens currently recommended in Europe, those including dolutegravir are associated with a lower risk of treatment failure. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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