Switching to boosted protease inhibitor plus a second antiretroviral drug (dual therapy) for treatment simplification: a multicenter observational study

BMC Infectious Diseases

Research Article

Vanni Borghi¹  Patrizia Lorenzini²  Alberto Giannetti²  Adriana Ammassari²  Rita Bellagamba²  Mauro Zaccarelli²  Laura Loiacono²  Andrea Antinori²  Simona Di Giambenedetto³  Massimiliano Fabbiani⁴  Gaetana Sterrantino⁵  Gabriella D’Ettorre⁶  Alessandra Latini⁷  Manuela Colafigli⁷ 

[1] Azienda Ospedaliero Universitaria, Clinic of Infectious Diseases, Modena, Italy;Clinical Department, National Institute for the Infectious Diseases “Lazzaro Spallanzani”, Rome, Italy;Department of Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy;Department of Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy;Division of Infectious Diseases, Department of Internal Medicine, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy;Division of Infectious Diseases, Careggi Hospital, Florence, Italy;Policlinico Universitario “Umberto I”, Clinic of Infectious Diseases, Rome, Italy;San Gallicano Dermatologic Institute (IRCCS), Clinic of Dermatology and Infectious Diseases, Rome, Italy;

关键词: Antiretroviral therapy;    Dual therapy;    Treatment simplification;    Darunavir Atazanavir;    Raltegravir;   

DOI  :  10.1186/s12879-016-1703-z

 received in 2016-03-20, accepted in 2016-07-08,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundAim of the study was to assess predictors of discontinuation/toxicity of boosted PI-based (PI/r) dual therapy (DT).MethodsObservational, retrospective switch study in patients successfully treated with triple drugs regimen. Patients switched to PI/r based DT [darunavir (DRV/r), lopinavir (LPV/r) or atazanavir (ATV/r)] plus a second drug: [raltegravir (RAL), maraviroc (MVC) etravirine (ETR), lamivudine (3TC) or tenofovir (TDF)] between 2009 and 2014 were included. The effect of each drug as well as other clinical and virological cofactors over treatment discontinuation (TD) was assessed using survival analysis.ResultsOverall, 376 patients were included with mean follow-up of 73 weeks. The most commonly used drugs in DT were DRV/r (63.0 %) and RAL (53.7 %). TD was observed in 77 (20,4 %) patients: 38 (10,1 %) virological failure, 35 (9,3 %) toxicity/intolerance (4 deaths) and 4 (1 %) interruptions for patients decision. At Cox Model, adjusted by demographic and laboratory variables, DRV/r and ATV/r significantly reduced the likelihood of TD and longer treatment was associated with lower risk, while low CD4 count at baseline and number of previous regimens with a higher risk. Moreover, RAL and 3TC use were significantly associated with lower TD by toxicity.ConclusionsIn our clinical practice experience, switching virologically suppressed patients to PI/r based DT showed adequate safety and efficacy, so that it may be used in selected patients with specific medical needs.

【 授权许可】

CC BY   
© The Author(s). 2016