Efficacy and safety of switching to raltegravir plus atazanavir dual therapy in pretreated HIV-1-infected patients over 144 weeks: a cohort study

Autor:	Christine Koeppel, Patrice Muret, Marie-Laure Batard, David Rey, Michèle Priester, Samira Fafi-Kremer, Charlotte Sueur, Claudine Bernard-Henry, Pierre Gantner, Erik De Mautort, Christine Cheneau, Marialuisa Partisani
Rok vydání:	2014
Předmět:	Adult Male Microbiology (medical) medicine.medical_specialty Anti-HIV Agents Pyridines Atazanavir Sulfate HIV Infections Cohort Studies Antiretroviral Therapy Highly Active Raltegravir Potassium Internal medicine medicine Humans Dosing Adverse effect Retrospective Studies Ritonavir General Immunology and Microbiology business.industry Retrospective cohort study HIV Protease Inhibitors General Medicine Middle Aged Viral Load Raltegravir Pyrrolidinones Surgery Atazanavir Regimen Treatment Outcome Infectious Diseases HIV-1 Drug Therapy Combination Female business Oligopeptides Follow-Up Studies medicine.drug Cohort study
Zdroj:	Scandinavian Journal of Infectious Diseases. 46:838-845
ISSN:	1651-1980 0036-5548
Popis:	To decrease drug burden among HIV-1-positive adults, we need a new gold standard for antiretroviral therapy maintenance strategies.This retrospective study aimed to assess efficacy in maintenance strategy of atazanavir (ATV) and raltegravir (RAL) dual therapy. The proportion of patients with HIV-1 RNA40 copies/ml at specific time points was recorded. Immunological response, safety, and pharmacokinetics were assessed.Overall, 39 patients were switched to a RAL/ATV (n = 32) or RAL/ATV plus ritonavir (n = 7) regimen. Almost all patients (95%) received RAL twice daily. Most patients (70%) received a 400 mg ATV dosing per day, once (26%) or twice daily (44%). The percentages of virological success at weeks 24, 48, 96, and 144 were 92% (95% confidence interval (CI), 83-10), 86% (95% CI, 74-98), 70% (95% CI, 52-88), and 63% (95% CI, 42-84), respectively. Overall, 12 (31%) patients stopped dual therapy: 7 patients because of adverse events, mostly clinical myositis (n = 3). Confirmed virological failure occurred in three patients; two of them developed RAL resistance patterns. A significant increase in the CD4+/CD8 + T-cell ratio was observed at week 48 (p0.005). Only grade 1-2 adverse events were observed. Trough plasma levels presented a wide variability. Suggested trough concentrations were achieved in 79% and 94% of patients for ATV and RAL, respectively. An unboosted 400 mg per day ATV dosing seemed to be appropriate, regarding the targeted levels achieved and the lack of grade 3 or 4 hyperbilirubinemia.We demonstrated, on a 3-year follow-up, the efficacy and safety of RAL plus ATV maintenance dual therapy.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ad466edd2f0abb181f633f945d443f73 https://doi.org/10.3109/00365548.2014.947318 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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