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Highly active antiretroviral therapy including protease inhibitors does not confer a unique CD4 cell benefit. The AVANTI and INCAS Study Groups.
AIDS. 2000 Jul 07; 14(10):1383-8.AIDS

Abstract

OBJECTIVE

To determine if triple combination therapy, particularly including HIV protease inhibitors (PI), confers an unique immunological benefit that is independent of reductions of plasma viral load (pVL).

DESIGN

The correlation between changes from baseline in CD4 cell count and pVL was examined at all time points up to 52 weeks in three randomized clinical trials (AVANTI-2, AVANTI-3 and INCAS) that compared dual nucleoside therapy with triple combination therapy.

METHODS

Individual pVL and CD4 cell counts changes from baseline were entered into multivariate linear regression models for patients receiving double therapy and for those receiving triple therapy including a PI and/or a non-nucleoside reverse transcriptase inhibitor (NNRTI), and the null hypothesis was tested.

RESULTS

After 52 weeks of therapy, the relationship between changes from baseline CD4 cell count and pVL was independent of whether patients were assigned double or triple therapy (P = 0.23 and 0.69 for intercept and slope, respectively), or whether patients were assigned triple therapy including a PI or triple therapy including an NNRTI (P = 0.92 and 0.95, respectively). Less than 5% of patients ever had 'discordant' increases in both CD4 cell count and pVL compared with baseline, and this proportion was unrelated to the class of therapy used. 'Discordant' decreases from baseline in both parameters were observed in up to 35% of individuals. The correlation between pVL and CD4 cell count changes from baseline improved over time on therapy, regardless of the therapeutic regimen involved.

CONCLUSIONS

The data provide no evidence for a CD4 cell count benefit of highly active antiretroviral therapy (HAART) unique to triple therapy or PI-containing regimens.

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

10930153

Citation

"Highly Active Antiretroviral Therapy Including Protease Inhibitors Does Not Confer a Unique CD4 Cell Benefit. the AVANTI and INCAS Study Groups." AIDS (London, England), vol. 14, no. 10, 2000, pp. 1383-8.
Highly active antiretroviral therapy including protease inhibitors does not confer a unique CD4 cell benefit. The AVANTI and INCAS Study Groups. AIDS. 2000;14(10):1383-8.
(2000). Highly active antiretroviral therapy including protease inhibitors does not confer a unique CD4 cell benefit. The AVANTI and INCAS Study Groups. AIDS (London, England), 14(10), 1383-8.
Highly Active Antiretroviral Therapy Including Protease Inhibitors Does Not Confer a Unique CD4 Cell Benefit. the AVANTI and INCAS Study Groups. AIDS. 2000 Jul 7;14(10):1383-8. PubMed PMID: 10930153.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Highly active antiretroviral therapy including protease inhibitors does not confer a unique CD4 cell benefit. The AVANTI and INCAS Study Groups. PY - 2000/8/10/pubmed PY - 2001/2/28/medline PY - 2000/8/10/entrez SP - 1383 EP - 8 JF - AIDS (London, England) JO - AIDS VL - 14 IS - 10 N2 - OBJECTIVE: To determine if triple combination therapy, particularly including HIV protease inhibitors (PI), confers an unique immunological benefit that is independent of reductions of plasma viral load (pVL). DESIGN: The correlation between changes from baseline in CD4 cell count and pVL was examined at all time points up to 52 weeks in three randomized clinical trials (AVANTI-2, AVANTI-3 and INCAS) that compared dual nucleoside therapy with triple combination therapy. METHODS: Individual pVL and CD4 cell counts changes from baseline were entered into multivariate linear regression models for patients receiving double therapy and for those receiving triple therapy including a PI and/or a non-nucleoside reverse transcriptase inhibitor (NNRTI), and the null hypothesis was tested. RESULTS: After 52 weeks of therapy, the relationship between changes from baseline CD4 cell count and pVL was independent of whether patients were assigned double or triple therapy (P = 0.23 and 0.69 for intercept and slope, respectively), or whether patients were assigned triple therapy including a PI or triple therapy including an NNRTI (P = 0.92 and 0.95, respectively). Less than 5% of patients ever had 'discordant' increases in both CD4 cell count and pVL compared with baseline, and this proportion was unrelated to the class of therapy used. 'Discordant' decreases from baseline in both parameters were observed in up to 35% of individuals. The correlation between pVL and CD4 cell count changes from baseline improved over time on therapy, regardless of the therapeutic regimen involved. CONCLUSIONS: The data provide no evidence for a CD4 cell count benefit of highly active antiretroviral therapy (HAART) unique to triple therapy or PI-containing regimens. SN - 0269-9370 UR - https://www.unboundmedicine.com/medline/citation/10930153/Highly_active_antiretroviral_therapy_including_protease_inhibitors_does_not_confer_a_unique_CD4_cell_benefit__The_AVANTI_and_INCAS_Study_Groups_ L2 - https://Insights.ovid.com/pubmed?pmid=10930153 DB - PRIME DP - Unbound Medicine ER -