We evaluated predictive factors involved in durability and therapeutic failure of atazanavir (ATV)-based antiretroviral regimens with or without ritonavir (r) in real life setting. This retrospective study of HIV-1-positive patients evaluated the factors related to ATV continuance and the time-dependent probability of therapeutic failure (HIV-RNA >200 copies/mL and concomitant discontinuation of ATV). We also investigated the rate of therapeutic failure and the variations in total bilirubin levels from starting unboosted ATV-based regimens. The study involved 1030 patients: 183 treatment-naïve patients (17.8%) started ATV/r (17 subsequently switched to unboosted ATV); 653 (63.4%) switched to ATV/r from previous antiretroviral regimens (121 subsequently switched to unboosted ATV); and 194 (18.8%) switched to unboosted ATV from previous ATV-free regimens. The median ATV follow-up was 28 months (interquartile range 7-56). The risk of ATV discontinuation was significantly lower in patients switched to unboosted ATV from ATV/r (HR 0.45; p < 0.0001). The discontinuation of ATV correlated with female gender (HR 1.26; p = 0.035), use of a zidovudine/didanosine/stavudine containing backbone (HR 1.8; p = 0.004), and a baseline CD4+ cell counts of <200/μL (HR 1.54; p = 0.003), the last of which was also associated with a higher risk of therapeutic failure (HR 2.42; p = 0.001). Total bilirubin levels were significantly lower in the patients switching from ATV/r to unboosted ATV. Unboosted ATV-based therapies are safe and effective options in patients whose immuno-virological conditions are stable, and allow the long-term survival of ATV-containing regimeans.
Factors involved in continuance of atazanavir-based regimens : Results from a cohort of HIV1-positive patients / A. Giacomelli, L. Oreni, M. Franzetti, V. Di Cristo, E. Colella, A.L. Ridolfo, M. Galli, S. Rusconi. - In: ANTIVIRAL RESEARCH. - ISSN 0166-3542. - 129(2016 Feb 20), pp. 52-57.
|Titolo:||Factors involved in continuance of atazanavir-based regimens : Results from a cohort of HIV1-positive patients|
GIACOMELLI, ANDREA (Corresponding)
GALLI, MASSIMO (Penultimo)
RUSCONI, STEFANO (Ultimo)
|Parole Chiave:||antiretroviral; atazanavir; continuance; HIV; unboosted; virology; pharmacology|
|Settore Scientifico Disciplinare:||Settore MED/17 - Malattie Infettive|
|Data di pubblicazione:||20-feb-2016|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/j.antiviral.2016.02.010|
|Appare nelle tipologie:||01 - Articolo su periodico|