Tags

Type your tag names separated by a space and hit enter

Superior virological response to boosted protease inhibitor-based highly active antiretroviral therapy in an observational treatment programme.
HIV Med 2007; 8(2):80-5HM

Abstract

BACKGROUND

The use of boosted protease inhibitor (PI)-based antiretroviral therapy has become increasingly recommended in international HIV treatment consensus guidelines based on the results of randomized clinical trials. However, the impact of this new treatment strategy has not yet been evaluated in community-treated cohorts.

METHODS

We evaluated baseline characteristics and plasma HIV RNA responses to unboosted and boosted PI-based highly active antiretroviral therapy (HAART) among antiretroviral-naïve HIV-infected patients in British Columbia, Canada who initiated HAART between August 1997 and September 2003 and who were followed until September 2004. We evaluated time to HIV-1 RNA suppression (<500 HIV-1 RNA copies/mL) and HIV-1 RNA rebound (>or=500 copies/mL), while stratifying patients into those that received boosted and unboosted PI-based HAART as the initial regimen, using Kaplan-Meier methods and Cox proportional hazards regression.

RESULTS

During the study period, 682 patients initiated therapy with unboosted PI and 320 individuals initiated HAART with a boosted PI. Those who initiated therapy with a boosted PI were more likely to have a CD4 cell count <200 cells/muL and to have a plasma HIV RNA>100 000 copies/mL, and to have AIDS at baseline (all P<0.001). However, when we examined virological response rates, those who initiated HAART with a boosted PI achieved more rapid virological suppression [relative hazard 1.26, 95% confidence interval (CI) 1.06-1.51, P=0.010].

CONCLUSIONS

Patients prescribed boosted PIs achieved superior virological response rates despite baseline factors that have been associated with inferior virological responses to HAART. Despite the inherent limitations of observational studies which require this study be interpreted with caution, these findings support the use of boosted PIs for initial HAART therapy.

Authors+Show Affiliations

British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, BC, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17352763

Citation

Wood, E, et al. "Superior Virological Response to Boosted Protease Inhibitor-based Highly Active Antiretroviral Therapy in an Observational Treatment Programme." HIV Medicine, vol. 8, no. 2, 2007, pp. 80-5.
Wood E, Hogg RS, Yip B, et al. Superior virological response to boosted protease inhibitor-based highly active antiretroviral therapy in an observational treatment programme. HIV Med. 2007;8(2):80-5.
Wood, E., Hogg, R. S., Yip, B., Moore, D., Harrigan, P. R., & Montaner, J. S. (2007). Superior virological response to boosted protease inhibitor-based highly active antiretroviral therapy in an observational treatment programme. HIV Medicine, 8(2), pp. 80-5.
Wood E, et al. Superior Virological Response to Boosted Protease Inhibitor-based Highly Active Antiretroviral Therapy in an Observational Treatment Programme. HIV Med. 2007;8(2):80-5. PubMed PMID: 17352763.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Superior virological response to boosted protease inhibitor-based highly active antiretroviral therapy in an observational treatment programme. AU - Wood,E, AU - Hogg,R S, AU - Yip,B, AU - Moore,D, AU - Harrigan,P R, AU - Montaner,J S G, PY - 2007/3/14/pubmed PY - 2007/11/9/medline PY - 2007/3/14/entrez SP - 80 EP - 5 JF - HIV medicine JO - HIV Med. VL - 8 IS - 2 N2 - BACKGROUND: The use of boosted protease inhibitor (PI)-based antiretroviral therapy has become increasingly recommended in international HIV treatment consensus guidelines based on the results of randomized clinical trials. However, the impact of this new treatment strategy has not yet been evaluated in community-treated cohorts. METHODS: We evaluated baseline characteristics and plasma HIV RNA responses to unboosted and boosted PI-based highly active antiretroviral therapy (HAART) among antiretroviral-naïve HIV-infected patients in British Columbia, Canada who initiated HAART between August 1997 and September 2003 and who were followed until September 2004. We evaluated time to HIV-1 RNA suppression (<500 HIV-1 RNA copies/mL) and HIV-1 RNA rebound (>or=500 copies/mL), while stratifying patients into those that received boosted and unboosted PI-based HAART as the initial regimen, using Kaplan-Meier methods and Cox proportional hazards regression. RESULTS: During the study period, 682 patients initiated therapy with unboosted PI and 320 individuals initiated HAART with a boosted PI. Those who initiated therapy with a boosted PI were more likely to have a CD4 cell count <200 cells/muL and to have a plasma HIV RNA>100 000 copies/mL, and to have AIDS at baseline (all P<0.001). However, when we examined virological response rates, those who initiated HAART with a boosted PI achieved more rapid virological suppression [relative hazard 1.26, 95% confidence interval (CI) 1.06-1.51, P=0.010]. CONCLUSIONS: Patients prescribed boosted PIs achieved superior virological response rates despite baseline factors that have been associated with inferior virological responses to HAART. Despite the inherent limitations of observational studies which require this study be interpreted with caution, these findings support the use of boosted PIs for initial HAART therapy. SN - 1464-2662 UR - https://www.unboundmedicine.com/medline/citation/17352763/Superior_virological_response_to_boosted_protease_inhibitor_based_highly_active_antiretroviral_therapy_in_an_observational_treatment_programme_ L2 - https://doi.org/10.1111/j.1468-1293.2007.00430.x DB - PRIME DP - Unbound Medicine ER -