Tags

Type your tag names separated by a space and hit enter

Increased resilience to the development of drug resistance with modern boosted protease inhibitor-based highly active antiretroviral therapy.
J Infect Dis. 2008 Jul 01; 198(1):51-8.JI

Abstract

BACKGROUND

We explore the temporal and regimen-specific changes of HIV-1 drug resistance in a large cohort of antiretroviral-naive individuals starting highly active antiretroviral therapy (HAART).

METHODS

Individuals (n = 2350) initiating first HAART between August 1996 and November 2004 were followed until November 2005 (median follow-up, 4.8 years; n = 6066 tests). A logistic regression model was used to predict the probability of the emergence of resistance, adjusting for baseline predictors.

RESULTS

The cohort included 991 individuals initiating nonboosted protease inhibitor (PI)-based regimens, 475 initiating ritonavir-boosted PI-based regimens, and 884 initiating nonnucleoside reverse-transcriptase inhibitor (NNRTI)-based regimens. There was no difference in the development of resistance between nonboosted PI-based regimens (reference group) and NNRTI-based HAART regimens (odds ratio [OR], 1.09 [95% confidence interval {CI}, 0.84-1.42]), but there were greatly reduced odds for boosted PI-based regimens (OR, 0.42 [95% CI, 0.28-0.62]). Individuals initiating HAART more recently (2002-2004) were at a reduced risk of resistance, compared with those who started HAART between 1996 and 1998 (OR, 0.43 [95% CI, 0.30-0.61]).

CONCLUSIONS

Individuals initiating first HAART with a boosted PI-based regimen had a 2.4-fold lower OR for developing HIV drug resistance than did those starting nonboosted PI-based or NNRTI-based HAART, at all adherence levels. The data demonstrate marked temporal improvement in the likelihood of the development of drug resistance for those initiating more recent HAART regimens.

Authors+Show Affiliations

British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, British Columbia, 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

18498238

Citation

Lima, Viviane D., et al. "Increased Resilience to the Development of Drug Resistance With Modern Boosted Protease Inhibitor-based Highly Active Antiretroviral Therapy." The Journal of Infectious Diseases, vol. 198, no. 1, 2008, pp. 51-8.
Lima VD, Gill VS, Yip B, et al. Increased resilience to the development of drug resistance with modern boosted protease inhibitor-based highly active antiretroviral therapy. J Infect Dis. 2008;198(1):51-8.
Lima, V. D., Gill, V. S., Yip, B., Hogg, R. S., Montaner, J. S., & Harrigan, P. R. (2008). Increased resilience to the development of drug resistance with modern boosted protease inhibitor-based highly active antiretroviral therapy. The Journal of Infectious Diseases, 198(1), 51-8. https://doi.org/10.1086/588675
Lima VD, et al. Increased Resilience to the Development of Drug Resistance With Modern Boosted Protease Inhibitor-based Highly Active Antiretroviral Therapy. J Infect Dis. 2008 Jul 1;198(1):51-8. PubMed PMID: 18498238.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased resilience to the development of drug resistance with modern boosted protease inhibitor-based highly active antiretroviral therapy. AU - Lima,Viviane D, AU - Gill,Vikram S, AU - Yip,Benita, AU - Hogg,Robert S, AU - Montaner,Julio S G, AU - Harrigan,P Richard, PY - 2008/5/24/pubmed PY - 2008/7/31/medline PY - 2008/5/24/entrez SP - 51 EP - 8 JF - The Journal of infectious diseases JO - J Infect Dis VL - 198 IS - 1 N2 - BACKGROUND: We explore the temporal and regimen-specific changes of HIV-1 drug resistance in a large cohort of antiretroviral-naive individuals starting highly active antiretroviral therapy (HAART). METHODS: Individuals (n = 2350) initiating first HAART between August 1996 and November 2004 were followed until November 2005 (median follow-up, 4.8 years; n = 6066 tests). A logistic regression model was used to predict the probability of the emergence of resistance, adjusting for baseline predictors. RESULTS: The cohort included 991 individuals initiating nonboosted protease inhibitor (PI)-based regimens, 475 initiating ritonavir-boosted PI-based regimens, and 884 initiating nonnucleoside reverse-transcriptase inhibitor (NNRTI)-based regimens. There was no difference in the development of resistance between nonboosted PI-based regimens (reference group) and NNRTI-based HAART regimens (odds ratio [OR], 1.09 [95% confidence interval {CI}, 0.84-1.42]), but there were greatly reduced odds for boosted PI-based regimens (OR, 0.42 [95% CI, 0.28-0.62]). Individuals initiating HAART more recently (2002-2004) were at a reduced risk of resistance, compared with those who started HAART between 1996 and 1998 (OR, 0.43 [95% CI, 0.30-0.61]). CONCLUSIONS: Individuals initiating first HAART with a boosted PI-based regimen had a 2.4-fold lower OR for developing HIV drug resistance than did those starting nonboosted PI-based or NNRTI-based HAART, at all adherence levels. The data demonstrate marked temporal improvement in the likelihood of the development of drug resistance for those initiating more recent HAART regimens. SN - 0022-1899 UR - https://www.unboundmedicine.com/medline/citation/18498238/Increased_resilience_to_the_development_of_drug_resistance_with_modern_boosted_protease_inhibitor_based_highly_active_antiretroviral_therapy_ L2 - https://academic.oup.com/jid/article-lookup/doi/10.1086/588675 DB - PRIME DP - Unbound Medicine ER -