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Differential Effects of Efavirenz, Lopinavir/r, and Atazanavir/r on the Initial Viral Decay Rate in Treatment Naive HIV-1-Infected Patients

Eden, Arvid; Andersson, Lars-Magnus; Andersson, Orjan; Flamholc, Leo LU ; Josephson, Filip; Nilsson, Staffan; Ormaasen, Vidar; Svedhem, Veronica; Sall, Christer and Sonnerborg, Anders, et al. (2010) In AIDS Research and Human Retroviruses 26(5). p.533-540
Abstract
Initial viral decay rate may be useful when comparing the relative potency of antiretroviral regimens. Two hundred twenty-seven ART-naive patients were randomized to receive efavirenz (EFV) (n=74), lopinavir/ritonavir (LPV/r) (n=77), or atazanavir/ritonavir (ATV/r) (n=79) in combination with two NRTIs. The most frequently used NRTI combinations in the EFV and ATV/r groups were the nonthymidine analogues tenofovir and emtricitabine or lamivudine (70% and 68%, respectively) and, in the LPV/r group, lamivudine and the thymidine analogue zidovudine (89%). HIV-1 RNA was monitored during the first 28 days after treatment initiation. Phase 1 and 2 decay rate was estimated in a subset of 157 patients by RNA decrease from days 0 to 7, and days 14... (More)
Initial viral decay rate may be useful when comparing the relative potency of antiretroviral regimens. Two hundred twenty-seven ART-naive patients were randomized to receive efavirenz (EFV) (n=74), lopinavir/ritonavir (LPV/r) (n=77), or atazanavir/ritonavir (ATV/r) (n=79) in combination with two NRTIs. The most frequently used NRTI combinations in the EFV and ATV/r groups were the nonthymidine analogues tenofovir and emtricitabine or lamivudine (70% and 68%, respectively) and, in the LPV/r group, lamivudine and the thymidine analogue zidovudine (89%). HIV-1 RNA was monitored during the first 28 days after treatment initiation. Phase 1 and 2 decay rate was estimated in a subset of 157 patients by RNA decrease from days 0 to 7, and days 14 to 28. One-way ANOVA and subsequent Tukey's post hoc tests were used for groupwise comparisons. Mean (95% CI) HIV-1 RNA reductions from days 0 to 28 were 2.59 (2.45-2.73), 2.42 (2.27-2.57), and 2.13 (2.01-2.25) log(10) copies/ml for the EFV-, LPV/r-, and ATV/r-based treatment groups, respectively, with a significantly larger decrease in the EFV-based group at all time points compared with ATV/r (p<0.0001), and with LPV/r at days 7-21 (p<0.0001-0.03). LPV/r gave a greater RNA decrease compared with ATV/r from day 14 (p=0.02). Phase 1 decay rate was significantly higher in the EFV group compared with LPV/r (p=0.003) or ATV/r (p<0.0001). No difference was found in phase 2 decrease. EFV-based treatment gave a more rapid decline in HIV-1 RNA than did either of the boosted protease inhibitor-based regimens. The observed differences may reflect different inherent regimen potencies. (Less)
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AIDS Research and Human Retroviruses
volume
26
issue
5
pages
533 - 540
publisher
Mary Ann Liebert, Inc.
external identifiers
  • wos:000277736600005
  • scopus:77952561797
ISSN
1931-8405
DOI
10.1089/aid.2009.0177
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English
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32a7ca18-b14c-46a9-b8d3-466849eac1fd (old id 1618079)
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http://www.liebertonline.com/doi/abs/10.1089/aid.2009.0177?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3Dncbi.nlm.nih.gov
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@article{32a7ca18-b14c-46a9-b8d3-466849eac1fd,
  abstract     = {Initial viral decay rate may be useful when comparing the relative potency of antiretroviral regimens. Two hundred twenty-seven ART-naive patients were randomized to receive efavirenz (EFV) (n=74), lopinavir/ritonavir (LPV/r) (n=77), or atazanavir/ritonavir (ATV/r) (n=79) in combination with two NRTIs. The most frequently used NRTI combinations in the EFV and ATV/r groups were the nonthymidine analogues tenofovir and emtricitabine or lamivudine (70% and 68%, respectively) and, in the LPV/r group, lamivudine and the thymidine analogue zidovudine (89%). HIV-1 RNA was monitored during the first 28 days after treatment initiation. Phase 1 and 2 decay rate was estimated in a subset of 157 patients by RNA decrease from days 0 to 7, and days 14 to 28. One-way ANOVA and subsequent Tukey's post hoc tests were used for groupwise comparisons. Mean (95% CI) HIV-1 RNA reductions from days 0 to 28 were 2.59 (2.45-2.73), 2.42 (2.27-2.57), and 2.13 (2.01-2.25) log(10) copies/ml for the EFV-, LPV/r-, and ATV/r-based treatment groups, respectively, with a significantly larger decrease in the EFV-based group at all time points compared with ATV/r (p&lt;0.0001), and with LPV/r at days 7-21 (p&lt;0.0001-0.03). LPV/r gave a greater RNA decrease compared with ATV/r from day 14 (p=0.02). Phase 1 decay rate was significantly higher in the EFV group compared with LPV/r (p=0.003) or ATV/r (p&lt;0.0001). No difference was found in phase 2 decrease. EFV-based treatment gave a more rapid decline in HIV-1 RNA than did either of the boosted protease inhibitor-based regimens. The observed differences may reflect different inherent regimen potencies.},
  author       = {Eden, Arvid and Andersson, Lars-Magnus and Andersson, Orjan and Flamholc, Leo and Josephson, Filip and Nilsson, Staffan and Ormaasen, Vidar and Svedhem, Veronica and Sall, Christer and Sonnerborg, Anders and Tunback, Petra and Gisslen, Magnus},
  issn         = {1931-8405},
  language     = {eng},
  number       = {5},
  pages        = {533--540},
  publisher    = {Mary Ann Liebert, Inc.},
  series       = {AIDS Research and Human Retroviruses},
  title        = {Differential Effects of Efavirenz, Lopinavir/r, and Atazanavir/r on the Initial Viral Decay Rate in Treatment Naive HIV-1-Infected Patients},
  url          = {http://dx.doi.org/10.1089/aid.2009.0177},
  volume       = {26},
  year         = {2010},
}