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Clin Infect Dis. 2011 May;52(10):1257-66. doi: 10.1093/cid/cir123.

Immunovirological response to triple nucleotide reverse-transcriptase inhibitors and ritonavir-boosted protease inhibitors in treatment-naive HIV-2-infected patients: The ACHIEV2E Collaboration Study Group.

Collaborators (181)

Matheron S, Tubiana R, Meyohas MC, Bernasconi C, Dupin N, Slama L, Ponscarme D, Lascoux-Combe C, Timsit FJ, Khuong MA, Rami A, Teichner E, Semaille C, Quertainmont Y, Bloch M, Froguel E, Genet P, Leprêtre A, Zucman D, Karmochkine M, Blum L, Chevojon P, Olivier C, Delassus JL, Bodard L, Imbert P, Boué F, Billaud E, Drobacheff-Thiébaut C, Cotte L, Allègre T, Bazin C, Nau P, Debab Y, Leclercq P, Arvieux C, Lafeuillade A, Ragnaud JM, Dutronc H, Perré P, Montagne N, Reynes J, Jacomet C, Sanderson F, Rey D, Longy-Boursier M, Chennebault JM, Granet P, de Wolf F, Bezemer DO, Gras LA, Kesselring AM, van Sighem AI, Smit C, Zhang S, Zaheri S, Prins JM, Kuijpers TW, Scherpbier HJ, Boer K, van der Meer JT, Wit FW, Godfried MH, Reiss P, Haverkort ME, van der Poll T, Nellen FJ, Lange JM, Geerlings SE, van Vugt M, Vrouenraets SM, Pajkrt D, Bos JC, van der Valk M, Schreij G, Lowe S, Lashof AO, Pronk MJ, Bravenboer B, van der Ende ME, de Vries-Sluijs TE, Schurink CA, van der Feltz M, Nouwen JL, Gelinck LB, Verbon A, Rijnders BJ, van de Ven-de Ruiter ED, Slobbe L, Hartwig NG, Driessen GJ, Branger J, Kauffmann RH, Schippers EF, Groeneveld PH, Alleman MA, Bouwhuis JW, ten Kate RW, Soetekouw R, Kroon FP, van den Broek PJ, van Dissel JT, Arend SM, van Nieuwkoop C, de Boer MG, Jolink H, den Hollander JG, Pogany K, Kortmann W, van Twillert G, Vriesendorp R, Leyten EM, ten Napel CH, Kootstra GJ, Brinkman K, Blok WL, Frissen PH, Schouten WE, van den Berk GE, Juttmann JR, van Kasteren ME, Brouwer AE, Veenstra J, Lettinga KD, Mulder JW, van Gorp EC, Smit PM, Weijer S, van Eeden A, Verhagen DW, Sprenger HG, Doedens R, Scholvinck EH, van Assen S, Stek CJ, Koopmans PP, de Groot R, Keuter M, van der Ven AJ, ter Hofstede HJ, van der Flier M, Brouwer AM, Dofferhoff AS, Hoepelman AI, Mudrikova T, Schneider MM, Jaspers CA, Ellerbroek PM, Peters EJ, Maarschalk-Ellerbroek LJ, Oosterheert JJ, Arends JE, Wassenberg MW, van der Hilst JC, Danner SA, van Agtmael MA, de Vocht J, Perenboom RM, Claessen FA, Bierman WF, de Jong EV, bij de Vaate EA, Geelen SP, Wolfs TF, Richter C, van der Berg JP, Gisolf EH, van den Berge M, Stegeman A, van Houte DP, Polée MB, van Vonderen MG, Winkel C, Duits AJ, Antunes F, França L, Mansinho K, Valadas E, Soriano V, Trevino A, Rodes B.

Abstract

BACKGROUND:

Triple nucleoside reverse-transcriptase inhibitors (NRTIs) are recommended by the World Health Organization as first-line regimen in treatment-naïve HIV-2-infected patients. However, ritonavir-boosted protease inhibitor (PI/r)-containing regimens are frequently prescribed. In the absence of previous randomized trials, we retrospectively compared these regimens in observational cohorts.

METHODS:

HIV-2-infected patients from 7 European cohorts who started triple NRTI or PI/r since January 1998 were included. Piecewise linear models were used to estimate CD4 cell count and plasma HIV-2 RNA level slopes, differentiating an early phase (until end of month 3) and a second phase (months 4-12). On-treatment analyses censored data at major treatment modification and systematically at month 12.

RESULTS:

Forty-four patients started triple NRTI therapy and 126 started PI/r therapy. Overall, the median CD4 cell count was 191 cells/mm(3) and the median plasma HIV-2 RNA level was ≥2.7 log(10) copies/ml in 61% of the patients at combination antiretroviral therapy (cART) initiation; the median duration of the first cART was 20 months, not differing between groups. PI/r regimens were associated with better CD4 cell count and HIV-2 RNA level outcomes, compared with NRTI regimens. Estimated CD4 cell count slopes were +6 and +12 cells/mm(3)/month during the early phase (P = .22), and -60 cells/mm(3)/year versus +76 cells/mm(3)/year during the second phase (P = .002), for triple NRTI and PI/r, respectively. Estimated mean HIV-2 RNA levels at month 12 in patients with detectable viremia at cART initiation were 4.0 and 2.2 log(10) copies/ml, respectively (P = .005).

CONCLUSIONS:

In this observational study, PI/r-containing regimens showed superior efficacy over triple NRTI regimens as first-line therapy in HIV-2-infected patients.

PMID:
21507923
[PubMed - indexed for MEDLINE]
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