CD4-guided scheduled treatment interruptions compared with continuous therapy for patients infected with HIV-1: results of the Staccato randomised trial
| Autor: | Ploenchan Chetchotisakd, Reto Nüesch, Claudette S. Satchell, David A. Cooper, Warangkana Munsakul, Kiat Ruxrungtham, Michelle Le Braz, Enos Bernasconi, Daniel Genné, Jintanat Ananworanich, Phitsanu Raksakulkarn, Sabine Yerly, Praphan Phanuphak, Urs Karrer, Matthias Cavassini, Dominic Leduc, Sunee Sirivichayakul, Andrew Hill, Wisit Prasithsirikul, Angèle Gayet-Ageron, Bernard Hirschel, Hansjakob Furrer, Sasisopin Kiertiburanakul, Thomas V. Perneger, Somboon Tansuphasawasdikul, Luc Perrin, Pietro Vernazza |
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| Přispěvatelé: | Other departments |
| Jazyk: | angličtina |
| Rok vydání: | 2006 |
| Předmět: |
Adult
Male medicine.medical_specialty Numerical data Adolescent Endpoint Determination HIV Infections Staccato Drug Administration Schedule Acquired immunodeficiency syndrome (AIDS) Antiretroviral Therapy Highly Active Internal medicine medicine Humans Sida Adverse effect Aged ddc:616 biology business.industry Hiv-1 General Medicine Drug holiday Middle Aged biology.organism_classification medicine.disease Surgery CD4 Lymphocyte Count Clinical trial HIV-1 HIV Infections/ drug therapy/immunology/transmission Female Viral disease business Viral load Antiretroviral Therapy Highly Active/adverse effects/economics/ statistics & |
| Zdroj: | The Lancet, Vol. 368, No 9534 (2006) pp. 459-465 Lancet, 368(9534), 459-465. Elsevier Limited |
| ISSN: | 0140-6736 |
| DOI: | 10.1016/s0140-6736(06)69153-8 |
| Popis: | BACKGROUND: Stopping antiretroviral therapy in patients with HIV-1 infection can reduce costs and side-effects, but carries the risk of increased immune suppression and emergence of resistance. METHODS: 430 patients with CD4-positive T-lymphocyte (CD4) counts greater than 350 cells per muL, and viral load less than 50 copies per mL were randomised to continued therapy (n=146) or scheduled treatment interruptions (n=284). Median time on randomised treatment was 21.9 months (range 16.4-25.3). Primary endpoints were proportion of patients with viral load less than 50 copies per mL at the end of the trial, and amount of drugs used. Analysis was intention-to-treat. This study is registered at ClinicalTrials.gov with the identifier NCT00113126. FINDINGS: Drug savings in the scheduled treatment interruption group, compared with continuous treatment, amounted to 61.5%. 257 of 284 (90.5%) patients in the scheduled treatment interruption group reached a viral load less than 50 copies per mL, compared with 134 of 146 (91.8%) in the continued treatment group (difference 1.3%, 95% CI-4.3 to 6.9, p=0.90). No AIDS-defining events occurred. Diarrhoea and neuropathy were more frequent with continuous treatment; candidiasis was more frequent with scheduled treatment interruption. Ten patients (2.3%) had resistance mutations, with no significant differences between groups. INTERPRETATION: Drug savings with scheduled treatment interruption were substantial, and no evidence of increased treatment resistance emerged. Treatment-related adverse events were more frequent with continuous treatment, but low CD4 counts and minor manifestations of HIV infection were more frequent with scheduled treatment interruption. |
| Databáze: | OpenAIRE |
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