Long-term effectiveness of recommended boosted protease inhibitor-based antiretroviral therapy in Europe

on behalf of the EuroSIDA study group

doi:10.1111/hiv.12581

Long-term effectiveness of recommended boosted protease inhibitor-based antiretroviral therapy in Europe

on behalf of the EuroSIDA study group

Department of Clinical Medicine

2 Citations (Scopus)

Abstract

Objectives: The aim of the study was to evaluate the long-term response to antiretroviral treatment (ART) based on atazanavir/ritonavir (ATZ/r)-, darunavir/ritonavir (DRV/r)-, and lopinavir/ritonavir (LPV/r)-containing regimens. Methods: Data were analysed for 5678 EuroSIDA-enrolled patients starting a DRV/r-, ATZ/r- or LPV/r-containing regimen between 1 January 2000 and 30 June 2013. Separate analyses were performed for the following subgroups of patients: (1) ART-naïve subjects (8%) at ritonavir-boosted protease inhibitor (PI/r) initiation; (2) ART-experienced individuals (44%) initiating the new PI/r with a viral load (VL) ≤500 HIV-1 RNA copies/mL; and (3) ART-experienced patients (48%) initiating the new PI/r with a VL >500 copies/mL. Virological failure (VF) was defined as two consecutive VL measurements >200 copies/mL ≥24 weeks after PI/r initiation. Kaplan–Meier and multivariable Cox models were used to compare risks of failure by PI/r-based regimen. The main analysis was performed with intention-to-treat (ITT) ignoring treatment switches. Results: The time to VF favoured DRV/r over ATZ/r, and both were superior to LPV/r (log-rank test; P < 0.02) in all analyses. Nevertheless, the risk of VF in ART-naïve patients was similar regardless of the PI/r initiated after controlling for potential confounders. The risk of VF in both treatment-experienced groups was lower for DRV/r than for ATZ/r, which, in turn, was lower than for LPV/r-based ART. Conclusions: Although confounding by indication and calendar year cannot be completely ruled out, in ART-experienced subjects the long-term effectiveness of DRV/r-containing regimens appears to be greater than that of ATZ/r and LPV/r.

Original language	English
Journal	HIV Medicine
Volume	19
Issue number	5
Pages (from-to)	324-338
Number of pages	15
ISSN	1464-2662
DOIs	https://doi.org/10.1111/hiv.12581
Publication status	Published - 2018

Keywords

antiretroviral therapy-experienced patients
antiretroviral therapy-naïve patients
atazanavir/ritonavir
darunavir/ritonavir
lopinavir/ritonavir

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/hiv.12581

Cite this

@article{dfde7507cf7146e1b7a3a1052cf799b0,

title = "Long-term effectiveness of recommended boosted protease inhibitor-based antiretroviral therapy in Europe",

abstract = "Objectives: The aim of the study was to evaluate the long-term response to antiretroviral treatment (ART) based on atazanavir/ritonavir (ATZ/r)-, darunavir/ritonavir (DRV/r)-, and lopinavir/ritonavir (LPV/r)-containing regimens. Methods: Data were analysed for 5678 EuroSIDA-enrolled patients starting a DRV/r-, ATZ/r- or LPV/r-containing regimen between 1 January 2000 and 30 June 2013. Separate analyses were performed for the following subgroups of patients: (1) ART-na{\"i}ve subjects (8%) at ritonavir-boosted protease inhibitor (PI/r) initiation; (2) ART-experienced individuals (44%) initiating the new PI/r with a viral load (VL) ≤500 HIV-1 RNA copies/mL; and (3) ART-experienced patients (48%) initiating the new PI/r with a VL >500 copies/mL. Virological failure (VF) was defined as two consecutive VL measurements >200 copies/mL ≥24 weeks after PI/r initiation. Kaplan–Meier and multivariable Cox models were used to compare risks of failure by PI/r-based regimen. The main analysis was performed with intention-to-treat (ITT) ignoring treatment switches. Results: The time to VF favoured DRV/r over ATZ/r, and both were superior to LPV/r (log-rank test; P < 0.02) in all analyses. Nevertheless, the risk of VF in ART-na{\"i}ve patients was similar regardless of the PI/r initiated after controlling for potential confounders. The risk of VF in both treatment-experienced groups was lower for DRV/r than for ATZ/r, which, in turn, was lower than for LPV/r-based ART. Conclusions: Although confounding by indication and calendar year cannot be completely ruled out, in ART-experienced subjects the long-term effectiveness of DRV/r-containing regimens appears to be greater than that of ATZ/r and LPV/r.",

keywords = "antiretroviral therapy-experienced patients, antiretroviral therapy-na{\"i}ve patients, atazanavir/ritonavir, darunavir/ritonavir, lopinavir/ritonavir",

author = "Santos, {J. R.} and A. Cozzi-Lepri and A. Phillips and {De Wit}, S. and C. Pedersen and P. Reiss and A. Blaxhult and A. Lazzarin and M. Sluzhynska and C. Orkin and C. Duvivier and J. Bogner and P. Gargalianos-Kakolyris and P. Schmid and G. Hassoun and I. Khromova and M. Beniowski and V. Hadziosmanovic and D. Sedlacek and R. Paredes and Lundgren, {J. D.} and M. Losso and M. Kundro and B. Schmied and R. Zangerle and I. Karpov and A. Vassilenko and Mitsura, {V. M.} and D. Paduto and N. Clumeck and M. Delforge and E. Florence and L. Vandekerckhove and J. Begovac and L. Machala and D. Jilich and G. Kronborg and T. Benfield and J. Gerstoft and T. Katzenstein and M{\o}ller, {N. F.} and L. Ostergaard and L. Wiese and Nielsen, {L. N.} and K. Zilmer and J. Smidt and M. Ristola and I. Aho and O. Kirk and Fischer, {A. H.} and {on behalf of the EuroSIDA study group}",

year = "2018",

doi = "10.1111/hiv.12581",

language = "English",

volume = "19",

pages = "324--338",

journal = "HIV Medicine",

issn = "1464-2662",

publisher = "Wiley-Blackwell",

number = "5",

}

TY - JOUR

T1 - Long-term effectiveness of recommended boosted protease inhibitor-based antiretroviral therapy in Europe

AU - Santos, J. R.

AU - Cozzi-Lepri, A.

AU - Phillips, A.

AU - De Wit, S.

AU - Pedersen, C.

AU - Reiss, P.

AU - Blaxhult, A.

AU - Lazzarin, A.

AU - Sluzhynska, M.

AU - Orkin, C.

AU - Duvivier, C.

AU - Bogner, J.

AU - Gargalianos-Kakolyris, P.

AU - Schmid, P.

AU - Hassoun, G.

AU - Khromova, I.

AU - Beniowski, M.

AU - Hadziosmanovic, V.

AU - Sedlacek, D.

AU - Paredes, R.

AU - Lundgren, J. D.

AU - Losso, M.

AU - Kundro, M.

AU - Schmied, B.

AU - Zangerle, R.

AU - Karpov, I.

AU - Vassilenko, A.

AU - Mitsura, V. M.

AU - Paduto, D.

AU - Clumeck, N.

AU - Delforge, M.

AU - Florence, E.

AU - Vandekerckhove, L.

AU - Begovac, J.

AU - Machala, L.

AU - Jilich, D.

AU - Kronborg, G.

AU - Benfield, T.

AU - Gerstoft, J.

AU - Katzenstein, T.

AU - Møller, N. F.

AU - Ostergaard, L.

AU - Wiese, L.

AU - Nielsen, L. N.

AU - Zilmer, K.

AU - Smidt, J.

AU - Ristola, M.

AU - Aho, I.

AU - Kirk, O.

AU - Fischer, A. H.

AU - on behalf of the EuroSIDA study group

PY - 2018

Y1 - 2018

N2 - Objectives: The aim of the study was to evaluate the long-term response to antiretroviral treatment (ART) based on atazanavir/ritonavir (ATZ/r)-, darunavir/ritonavir (DRV/r)-, and lopinavir/ritonavir (LPV/r)-containing regimens. Methods: Data were analysed for 5678 EuroSIDA-enrolled patients starting a DRV/r-, ATZ/r- or LPV/r-containing regimen between 1 January 2000 and 30 June 2013. Separate analyses were performed for the following subgroups of patients: (1) ART-naïve subjects (8%) at ritonavir-boosted protease inhibitor (PI/r) initiation; (2) ART-experienced individuals (44%) initiating the new PI/r with a viral load (VL) ≤500 HIV-1 RNA copies/mL; and (3) ART-experienced patients (48%) initiating the new PI/r with a VL >500 copies/mL. Virological failure (VF) was defined as two consecutive VL measurements >200 copies/mL ≥24 weeks after PI/r initiation. Kaplan–Meier and multivariable Cox models were used to compare risks of failure by PI/r-based regimen. The main analysis was performed with intention-to-treat (ITT) ignoring treatment switches. Results: The time to VF favoured DRV/r over ATZ/r, and both were superior to LPV/r (log-rank test; P < 0.02) in all analyses. Nevertheless, the risk of VF in ART-naïve patients was similar regardless of the PI/r initiated after controlling for potential confounders. The risk of VF in both treatment-experienced groups was lower for DRV/r than for ATZ/r, which, in turn, was lower than for LPV/r-based ART. Conclusions: Although confounding by indication and calendar year cannot be completely ruled out, in ART-experienced subjects the long-term effectiveness of DRV/r-containing regimens appears to be greater than that of ATZ/r and LPV/r.

AB - Objectives: The aim of the study was to evaluate the long-term response to antiretroviral treatment (ART) based on atazanavir/ritonavir (ATZ/r)-, darunavir/ritonavir (DRV/r)-, and lopinavir/ritonavir (LPV/r)-containing regimens. Methods: Data were analysed for 5678 EuroSIDA-enrolled patients starting a DRV/r-, ATZ/r- or LPV/r-containing regimen between 1 January 2000 and 30 June 2013. Separate analyses were performed for the following subgroups of patients: (1) ART-naïve subjects (8%) at ritonavir-boosted protease inhibitor (PI/r) initiation; (2) ART-experienced individuals (44%) initiating the new PI/r with a viral load (VL) ≤500 HIV-1 RNA copies/mL; and (3) ART-experienced patients (48%) initiating the new PI/r with a VL >500 copies/mL. Virological failure (VF) was defined as two consecutive VL measurements >200 copies/mL ≥24 weeks after PI/r initiation. Kaplan–Meier and multivariable Cox models were used to compare risks of failure by PI/r-based regimen. The main analysis was performed with intention-to-treat (ITT) ignoring treatment switches. Results: The time to VF favoured DRV/r over ATZ/r, and both were superior to LPV/r (log-rank test; P < 0.02) in all analyses. Nevertheless, the risk of VF in ART-naïve patients was similar regardless of the PI/r initiated after controlling for potential confounders. The risk of VF in both treatment-experienced groups was lower for DRV/r than for ATZ/r, which, in turn, was lower than for LPV/r-based ART. Conclusions: Although confounding by indication and calendar year cannot be completely ruled out, in ART-experienced subjects the long-term effectiveness of DRV/r-containing regimens appears to be greater than that of ATZ/r and LPV/r.

KW - antiretroviral therapy-experienced patients

KW - antiretroviral therapy-naïve patients

KW - atazanavir/ritonavir

KW - darunavir/ritonavir

KW - lopinavir/ritonavir

U2 - 10.1111/hiv.12581

DO - 10.1111/hiv.12581

M3 - Journal article

C2 - 29388732

AN - SCOPUS:85041304540

SN - 1464-2662

VL - 19

SP - 324

EP - 338

JO - HIV Medicine

JF - HIV Medicine

IS - 5

ER -

Long-term effectiveness of recommended boosted protease inhibitor-based antiretroviral therapy in Europe

Abstract

Keywords

UN SDGs

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