Lopinavir/ritonavir, atazanavir/ritonavir, and efavirenz in antiretroviral-naive HIV-1-infected individuals over 144 weeks: An open-label randomized controlled trial
(2013) In Scandinavian Journal of Infectious Diseases 45(7). p.543-551- Abstract
- Background: The objective of this study was to compare the efficacy of ritonavir boosted atazanavir versus ritonavir boosted lopinavir or efavirenz, all in combination with 2 nucleoside analogue reverse transcriptase inhibitors (NRTIs), over 144 weeks in antiretroviral-naive HIV-1-infected individuals. Methods: A prospective open-label randomized controlled trial was conducted at 29 sites in Sweden and Norway between April 2004 and December 2009. Patients were randomized to receive either efavirenz 600 mg once daily (EFV), or atazanavir 300 mg and ritonavir 100 mg once daily (AZV/r), or lopinavir 400 mg and ritonavir 100 mg twice daily (LPV/r). The primary endpoints were the proportion of patients with HIV-1 RNA <50 copies/ml at 48 and... (More)
- Background: The objective of this study was to compare the efficacy of ritonavir boosted atazanavir versus ritonavir boosted lopinavir or efavirenz, all in combination with 2 nucleoside analogue reverse transcriptase inhibitors (NRTIs), over 144 weeks in antiretroviral-naive HIV-1-infected individuals. Methods: A prospective open-label randomized controlled trial was conducted at 29 sites in Sweden and Norway between April 2004 and December 2009. Patients were randomized to receive either efavirenz 600 mg once daily (EFV), or atazanavir 300 mg and ritonavir 100 mg once daily (AZV/r), or lopinavir 400 mg and ritonavir 100 mg twice daily (LPV/r). The primary endpoints were the proportion of patients with HIV-1 RNA <50 copies/ml at 48 and 144 weeks. Results: Of 245 patients enrolled, 243 were randomized and 239 received the allocated intervention: 77 EFV, 81 AZV/r, and 81 LPV/r. Median (interquartile range) CD4 cell counts at baseline were 150 (80-200), 170 (80-220), and 150 (90-216) per microlitre, respectively. At week 48 the proportion (95% confidence interval (CI)) of patients achieving HIV-1 RNA <50 copies/ml was 86 (78-94)% in the EFV arm, 78 (69-87)% in the AZV/r arm and, 69 (59-78)% in the LPV/r arm in the intention-to-treat analysis. There was a significant difference between the EFV and LPV/r arm (p = 0.014). At week 144, the proportion (95% CI) of patients achieving HIV-1 RNA <50 copies/ml was 61 (50-72)%, 58 (47-69)%, 51 (41-63)%, respectively (p = 0.8). Patients with CD4 cell counts of <= 200/mu l or HIV-1 RNA > 100,000 copies/ml at baseline had similar response rates in all arms. Conclusion: EFV was superior to LPV/r at week 48, but there were no significant differences between the 3 arms in the long-term (144 weeks) follow-up. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/3921093
- author
- Andersson, Lars-Magnus ; Vesterbacka, Jan ; Blaxhult, Anders ; Flamholc, Leo LU ; Nilsson, Staffan ; Ormaasen, Vidar ; Sonnerborg, Anders and Gisslen, Magnus
- organization
- publishing date
- 2013
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Combination antiretroviral therapy, HIV-1, treatment-naive patients, randomized controlled trial
- in
- Scandinavian Journal of Infectious Diseases
- volume
- 45
- issue
- 7
- pages
- 543 - 551
- publisher
- Informa Healthcare
- external identifiers
-
- wos:000320380900008
- scopus:84879084363
- pmid:23294034
- ISSN
- 1651-1980
- DOI
- 10.3109/00365548.2012.756985
- language
- English
- LU publication?
- yes
- id
- 29e5b41c-a99d-4ff7-9340-2e255f07e7e0 (old id 3921093)
- date added to LUP
- 2016-04-01 13:10:41
- date last changed
- 2022-01-27 17:45:31
@article{29e5b41c-a99d-4ff7-9340-2e255f07e7e0,
abstract = {{Background: The objective of this study was to compare the efficacy of ritonavir boosted atazanavir versus ritonavir boosted lopinavir or efavirenz, all in combination with 2 nucleoside analogue reverse transcriptase inhibitors (NRTIs), over 144 weeks in antiretroviral-naive HIV-1-infected individuals. Methods: A prospective open-label randomized controlled trial was conducted at 29 sites in Sweden and Norway between April 2004 and December 2009. Patients were randomized to receive either efavirenz 600 mg once daily (EFV), or atazanavir 300 mg and ritonavir 100 mg once daily (AZV/r), or lopinavir 400 mg and ritonavir 100 mg twice daily (LPV/r). The primary endpoints were the proportion of patients with HIV-1 RNA <50 copies/ml at 48 and 144 weeks. Results: Of 245 patients enrolled, 243 were randomized and 239 received the allocated intervention: 77 EFV, 81 AZV/r, and 81 LPV/r. Median (interquartile range) CD4 cell counts at baseline were 150 (80-200), 170 (80-220), and 150 (90-216) per microlitre, respectively. At week 48 the proportion (95% confidence interval (CI)) of patients achieving HIV-1 RNA <50 copies/ml was 86 (78-94)% in the EFV arm, 78 (69-87)% in the AZV/r arm and, 69 (59-78)% in the LPV/r arm in the intention-to-treat analysis. There was a significant difference between the EFV and LPV/r arm (p = 0.014). At week 144, the proportion (95% CI) of patients achieving HIV-1 RNA <50 copies/ml was 61 (50-72)%, 58 (47-69)%, 51 (41-63)%, respectively (p = 0.8). Patients with CD4 cell counts of <= 200/mu l or HIV-1 RNA > 100,000 copies/ml at baseline had similar response rates in all arms. Conclusion: EFV was superior to LPV/r at week 48, but there were no significant differences between the 3 arms in the long-term (144 weeks) follow-up.}},
author = {{Andersson, Lars-Magnus and Vesterbacka, Jan and Blaxhult, Anders and Flamholc, Leo and Nilsson, Staffan and Ormaasen, Vidar and Sonnerborg, Anders and Gisslen, Magnus}},
issn = {{1651-1980}},
keywords = {{Combination antiretroviral therapy; HIV-1; treatment-naive patients; randomized controlled trial}},
language = {{eng}},
number = {{7}},
pages = {{543--551}},
publisher = {{Informa Healthcare}},
series = {{Scandinavian Journal of Infectious Diseases}},
title = {{Lopinavir/ritonavir, atazanavir/ritonavir, and efavirenz in antiretroviral-naive HIV-1-infected individuals over 144 weeks: An open-label randomized controlled trial}},
url = {{http://dx.doi.org/10.3109/00365548.2012.756985}},
doi = {{10.3109/00365548.2012.756985}},
volume = {{45}},
year = {{2013}},
}