In:
Antiviral Therapy, SAGE Publications, Vol. 17, No. 8 ( 2012-11), p. 1609-1613
Kurzfassung:
We assessed whether quadruple or triple-class therapy for the initial treatment of HIV-1 infection provides a virological benefit over standard triple therapy in patients with very high plasma viraemia. The assessment was made based on a national observational HIV cohort in the Netherlands. Methods Inclusion criteria were age ≥18 years, treatment-naive, plasma viral load (pVL) ≥500,000 copies/ml and initiation of quadruple or triple therapy between 2001 and 2011. Time to viral suppression, defined as pVL 〈 50 copies/ ml, was compared between the two groups using Kaplan– Meier plots and multivariate Cox regression analysis. Results A total of 675 patients were included: 125 (19%) initiated quadruple and 550 (81%) triple therapy. Median pVL was 5.9 (IQR 5.8–6.1) log 10 copies/ml in both groups ( P=0.49). 22 (18%) patients on quadruple and 63 (12%) on triple therapy interrupted the treatment regimen because of drug-related toxicity ( P=0.06). Median time to viral suppression was 5.8 (IQR 4.6–7.9) and 6.0 (4.0–9.4) months in the patients on quadruple and triple therapy, respectively (log-rank, P=0.42). In the adjusted Cox analysis, quadruple therapy was not associated with time to viral suppression (HR 1.07 [95% CI 0.86, 1.33], P=0.53). Similar results were seen when comparing triple- versus dual-class therapy ( n=72 versus n=601, respectively). Conclusions Initial quadruple- or triple-class therapy was equally effective as standard triple therapy in the suppression of HIV-1 in treatment-naive patients with very high viraemia and did not result in faster pVL decreases, but did expose patients to additional toxicity.
Materialart:
Online-Ressource
ISSN:
1359-6535
,
2040-2058
Sprache:
Englisch
Verlag:
SAGE Publications
Publikationsdatum:
2012
ZDB Id:
2118396-X
SSG:
15,3
