Effectiveness of ritonavir-boosted protease inhibitor monotherapy in the clinical setting: same results as in clinical trials? The PIMOCS Study Group
| Autor: | Adrian, Curran, Polyana, Monteiro, Pere, Domingo, Judit, Villar, Arkaitz, Imaz, Esteban, Martínez, Irene, Fernández, Hernando, Knobel, Daniel, Podzamczer, Jose Antonio, Iribarren, María, Peñaranda, Manuel, Crespo, Melcior, Riera |
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| Rok vydání: | 2014 |
| Předmět: |
Microbiology (medical)
Adult Male medicine.medical_specialty Drug-Related Side Effects and Adverse Reactions Hepatitis C virus protease inhibitors darunavir HIV Infections Pharmacology medicine.disease_cause Gastroenterology Lopinavir Maintenance Chemotherapy immune system diseases Internal medicine Medicine Humans Pharmacology (medical) Protease inhibitor (pharmacology) Adverse effect Darunavir Retrospective Studies Sulfonamides Ritonavir business.industry Hazard ratio HIV virus diseases HIV Protease Inhibitors Middle Aged Viral Load CD4 Lymphocyte Count lopinavir Infectious Diseases Treatment Outcome monotherapy HIV-1 Female business Viral load medicine.drug |
| Zdroj: | JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau instname |
| ISSN: | 1460-2091 0305-7453 |
| Popis: | OBJECTIVES Ritonavir-boosted protease inhibitor monotherapy (PIMT) is a maintenance strategy that prevents nucleoside reverse transcriptase inhibitor toxicity and reduces costs. Some trials compare PIMT with combined antiretroviral therapy, but restricted selection criteria and low sample size hamper data extrapolation to routine practice. Here, we analyse the effectiveness and safety of PIMT in clinical practice. METHODS This was a retrospective, observational, multicentre study. Adult HIV-1 patients receiving PIMT with darunavir or lopinavir were included. A Cox regression model identified independent predictors for virological failure (VF). RESULTS A total of 664 patients (435 on darunavir/ritonavir and 229 on lopinavir/ritonavir) [74% male, median age of 54 years, one-third with previous protease inhibitor VF, CD4 nadir 189 cells/mm(3) and 42% coinfected with hepatitis C virus (HCV)] were analysed. After a median follow-up of 16 months, 78% of patients (95% CI 74%-81%) remained free from therapeutic failure (TF) (change between ritonavir-boosted PIs not considered failure). At 12 months, by intention-to-treat analysis (change between ritonavir-boosted PIs equals failure), 83% of patients were free from TF (87% darunavir/ritonavir versus 77% lopinavir/ritonavir, P = 0.001). Regarding VF, 88% of patients maintained viral suppression at 12 months (93% darunavir/ritonavir versus 88% lopinavir/ritonavir, P = not significant). CD4 nadir |
| Databáze: | OpenAIRE |
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