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J Antimicrob Chemother. 2014 Sep;69(9):2536-40. doi: 10.1093/jac/dku157. Epub 2014 May 15.

Abacavir/lamivudine plus darunavir/ritonavir in routine clinical practice: a multicentre experience in antiretroviral therapy-naive and -experienced patients.

Author information

1
Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain dpodzamczer@bellvitgehospital.cat.
2
Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
3
Hospital Clínic, Barcelona, Spain.
4
Hospital Virgen del Rocío, Sevilla, Spain.
5
Hospital Carlos III, Madrid, Spain.
6
Hospital Puerta de Hierro, Majadahonda, Spain.
7
Hospital Carlos Haya, Málaga, Spain.
8
Hospital Universitario Central de Asturias, Oviedo, Spain.
9
Hospital Universitario Donostia, San Sebastián, Spain.
10
IrsiCaixa, Hospital Universitari 'Germans Trias i Pujol', Badalona, Spain Universitat Autònoma de Barcelona, Barcelona, Spain Universitat de Vic, Catalonia, Spain.
11
Hospital de Mataró, Mataró, Spain.
12
Hospital Universitario Rio Ortega, Valladolid, Spain.
13
Hospital del Mar, Barcelona, Spain.
14
Hospital General Universitario Gregorio Marañón, Madrid, Spain.
15
Hospital San Pedro, Logroño, Spain.
16
Hospital Clínico San Carlos, Madrid, Spain.
17
Hospital Xeral Cies, Vigo, Spain.
18
Hospital Reina Sofía, Córdoba, Spain.
19
Hospital Arnau de Vilanova, Valencia, Spain.
20
Hospital Universitario de Canarias, La Laguna, Spain.

Abstract

OBJECTIVES:

To present clinical experience with a regimen including abacavir/lamivudine + darunavir/ritonavir in a cohort of HIV-1-infected patients.

METHODS:

A retrospective, multicentre cohort study, including all consecutive adult HIV-1-infected patients who started abacavir/lamivudine + darunavir/ritonavir from April 2008 to December 2010 and had at least one follow-up visit. The primary endpoint was HIV-1 viral load (VL) <40 copies/mL at week 48.

RESULTS:

One hundred and eighty-three patients (42 naive and 141 experienced) from 19 hospitals in Spain were studied. The median follow-up was 26.7 (0.5-58.6) months, 79.8% were men, the median age was 47.1 (21.4-80.5) years, 26.2% had AIDS and 38.8% were positive for hepatitis C virus. At baseline, the median CD4 count was 246 cells/mm(3) in naive patients and 393 cells/mm(3) in experienced patients and the median VL was 4.80 and <1.59 log copies/mL, respectively. At week 48, 81.8% of naive patients and 84.2% of experienced patients receiving the regimen reached a VL <40 copies/mL, whereas at 96 weeks this occurred in 90.5% and 92.8%, respectively. CD4 cell count increases at 48 and 96 weeks were +176.5 and +283.5 cells/mm(3) in naive patients and +74.9 and +93 cells/mm(3) in experienced patients, respectively. Overall, 86 (47%) patients discontinued the study regimen, in many cases possibly related to non-medical reasons, such as drug switches to reduce cost or changes in address due to economic constraints. Three patients died of causes unrelated to therapy and 19 (10.4%) discontinued the regimen due to adverse events.

CONCLUSIONS:

In our cohort, abacavir/lamivudine + darunavir/ritonavir was safe, well tolerated and achieved high rates of virological suppression. In a proportion of patients, discontinuation of this effective regimen was possibly due to non-medical reasons.

KEYWORDS:

HIV treatment; protease inhibitors; viral response

PMID:
24833755
DOI:
10.1093/jac/dku157
[Indexed for MEDLINE]
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