Duration of first-line antiretroviral therapy with tenofovir and emtricitabine combined with atazanavir/ritonavir, efavirenz or lopinavir/ritonavir in the Italian ARCA cohort
To explore the durability of three first-line tenofovir/emtricitabine-based regimens in combination with atazanavir/ritonavir, efavirenz or lopinavir/ritonavir in HIV-1-infected patients. A retrospective, longitudinal, multicentre analysis of adult patients enrolled in the Antiretroviral Resistance...
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| Veröffentlicht in: | Journal of antimicrobial chemotherapy 2013-01, Vol.68 (1), p.200-205 |
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| creator | Di Biagio, Antonio Prinapori, Roberta Giannarelli, Diana Maggiolo, Franco Di Giambenedetto, Simona Borghi, Vanni Penco, Giovanni Cicconi, Paola Francisci, Daniela Sterrantino, Gaetana Zoncada, Alessia Monno, Laura Capetti, Amedeo Giacometti, Andrea |
| description | To explore the durability of three first-line tenofovir/emtricitabine-based regimens in combination with atazanavir/ritonavir, efavirenz or lopinavir/ritonavir in HIV-1-infected patients.
A retrospective, longitudinal, multicentre analysis of adult patients enrolled in the Antiretroviral Resistance Cohort Analysis (ARCA), a national prospective observational cohort of HIV-1-infected patients followed up at more than 100 clinical and laboratory units in Italy. Patients eligible were those starting first-line antiretroviral therapy between 1 June 2004 and 15 April 2011 and who were followed up for at least 6 months. The primary endpoint was durability, defined as the time from antiretroviral therapy initiation to first treatment modification. Time-dependent events were analysed by the Kaplan-Meier approach and the Cox proportional hazard model.
There are 26,000 HIV-infected patients in the ARCA database, of whom 1654 met study inclusion criteria. Six hundred and thirty-nine (38.6%) received efavirenz, 321 (19.4%) received atazanavir/ritonavir and 694 (41.9%) received lopinavir/ritonavir as a first-line regimen. Over a total observation period of 88 months, equivalent to more than 2805 person-years of follow-up, 618 patients underwent treatment modification. Lopinavir/ritonavir, given twice daily, was associated with a higher discontinuation rate than efavirenz- and atazanavir-based regimens [hazard ratio (HR) 1.83, 95% confidence interval (CI) 1.56-2.15, P = 0.001]. Comparing the once-daily regimens, the rate of discontinuation of efavirenz was higher than that of atazanavir/ritonavir (HR 1.39, 95% CI 1.06-1.83, P = 0.016).
Significant differences in treatment duration were observed among the three studied regimens. Once-daily regimens exhibited greater durability than the twice-daily regimen. Among the specific regimens examined, tenofovir/emtricitabine plus atazanavir/ritonavir showed the greatest durability. |
| doi_str_mv | 10.1093/jac/dks339 |
| format | Article |
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A retrospective, longitudinal, multicentre analysis of adult patients enrolled in the Antiretroviral Resistance Cohort Analysis (ARCA), a national prospective observational cohort of HIV-1-infected patients followed up at more than 100 clinical and laboratory units in Italy. Patients eligible were those starting first-line antiretroviral therapy between 1 June 2004 and 15 April 2011 and who were followed up for at least 6 months. The primary endpoint was durability, defined as the time from antiretroviral therapy initiation to first treatment modification. Time-dependent events were analysed by the Kaplan-Meier approach and the Cox proportional hazard model.
There are 26,000 HIV-infected patients in the ARCA database, of whom 1654 met study inclusion criteria. Six hundred and thirty-nine (38.6%) received efavirenz, 321 (19.4%) received atazanavir/ritonavir and 694 (41.9%) received lopinavir/ritonavir as a first-line regimen. Over a total observation period of 88 months, equivalent to more than 2805 person-years of follow-up, 618 patients underwent treatment modification. Lopinavir/ritonavir, given twice daily, was associated with a higher discontinuation rate than efavirenz- and atazanavir-based regimens [hazard ratio (HR) 1.83, 95% confidence interval (CI) 1.56-2.15, P = 0.001]. Comparing the once-daily regimens, the rate of discontinuation of efavirenz was higher than that of atazanavir/ritonavir (HR 1.39, 95% CI 1.06-1.83, P = 0.016).
Significant differences in treatment duration were observed among the three studied regimens. Once-daily regimens exhibited greater durability than the twice-daily regimen. Among the specific regimens examined, tenofovir/emtricitabine plus atazanavir/ritonavir showed the greatest durability.</description><identifier>ISSN: 0305-7453</identifier><identifier>EISSN: 1460-2091</identifier><identifier>DOI: 10.1093/jac/dks339</identifier><identifier>PMID: 22915463</identifier><language>eng</language><publisher>England: Oxford Publishing Limited (England)</publisher><subject><![CDATA[Adenine - administration & dosage ; Adenine - analogs & derivatives ; Anti-Retroviral Agents - administration & dosage ; Antiretroviral drugs ; Atazanavir Sulfate ; Benzoxazines - administration & dosage ; Cohort Studies ; Comparative analysis ; Deoxycytidine - administration & dosage ; Deoxycytidine - analogs & derivatives ; Drug Resistance, Viral - drug effects ; Drug Resistance, Viral - physiology ; Drug therapy ; Drug Therapy, Combination ; Emtricitabine ; HIV ; HIV Infections - drug therapy ; HIV Infections - epidemiology ; HIV-1 - drug effects ; Human immunodeficiency virus ; Humans ; Italy - epidemiology ; Longitudinal Studies ; Lopinavir - administration & dosage ; Oligopeptides - administration & dosage ; Organophosphonates - administration & dosage ; Pharmacology ; Prospective Studies ; Pyridines - administration & dosage ; Retrospective Studies ; Ritonavir - administration & dosage ; Tenofovir ; Time Factors]]></subject><ispartof>Journal of antimicrobial chemotherapy, 2013-01, Vol.68 (1), p.200-205</ispartof><rights>Copyright Oxford Publishing Limited(England) Jan 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-a90482bb92d7daaa8670ce0feea8cbf41c83fc533225be42704d5ac020cd66103</citedby><cites>FETCH-LOGICAL-c384t-a90482bb92d7daaa8670ce0feea8cbf41c83fc533225be42704d5ac020cd66103</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22915463$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Di Biagio, Antonio</creatorcontrib><creatorcontrib>Prinapori, Roberta</creatorcontrib><creatorcontrib>Giannarelli, Diana</creatorcontrib><creatorcontrib>Maggiolo, Franco</creatorcontrib><creatorcontrib>Di Giambenedetto, Simona</creatorcontrib><creatorcontrib>Borghi, Vanni</creatorcontrib><creatorcontrib>Penco, Giovanni</creatorcontrib><creatorcontrib>Cicconi, Paola</creatorcontrib><creatorcontrib>Francisci, Daniela</creatorcontrib><creatorcontrib>Sterrantino, Gaetana</creatorcontrib><creatorcontrib>Zoncada, Alessia</creatorcontrib><creatorcontrib>Monno, Laura</creatorcontrib><creatorcontrib>Capetti, Amedeo</creatorcontrib><creatorcontrib>Giacometti, Andrea</creatorcontrib><creatorcontrib>ARCA Collaborative Group</creatorcontrib><creatorcontrib>on behalf of the ARCA Collaborative Group</creatorcontrib><title>Duration of first-line antiretroviral therapy with tenofovir and emtricitabine combined with atazanavir/ritonavir, efavirenz or lopinavir/ritonavir in the Italian ARCA cohort</title><title>Journal of antimicrobial chemotherapy</title><addtitle>J Antimicrob Chemother</addtitle><description>To explore the durability of three first-line tenofovir/emtricitabine-based regimens in combination with atazanavir/ritonavir, efavirenz or lopinavir/ritonavir in HIV-1-infected patients.
A retrospective, longitudinal, multicentre analysis of adult patients enrolled in the Antiretroviral Resistance Cohort Analysis (ARCA), a national prospective observational cohort of HIV-1-infected patients followed up at more than 100 clinical and laboratory units in Italy. Patients eligible were those starting first-line antiretroviral therapy between 1 June 2004 and 15 April 2011 and who were followed up for at least 6 months. The primary endpoint was durability, defined as the time from antiretroviral therapy initiation to first treatment modification. Time-dependent events were analysed by the Kaplan-Meier approach and the Cox proportional hazard model.
There are 26,000 HIV-infected patients in the ARCA database, of whom 1654 met study inclusion criteria. Six hundred and thirty-nine (38.6%) received efavirenz, 321 (19.4%) received atazanavir/ritonavir and 694 (41.9%) received lopinavir/ritonavir as a first-line regimen. Over a total observation period of 88 months, equivalent to more than 2805 person-years of follow-up, 618 patients underwent treatment modification. Lopinavir/ritonavir, given twice daily, was associated with a higher discontinuation rate than efavirenz- and atazanavir-based regimens [hazard ratio (HR) 1.83, 95% confidence interval (CI) 1.56-2.15, P = 0.001]. Comparing the once-daily regimens, the rate of discontinuation of efavirenz was higher than that of atazanavir/ritonavir (HR 1.39, 95% CI 1.06-1.83, P = 0.016).
Significant differences in treatment duration were observed among the three studied regimens. Once-daily regimens exhibited greater durability than the twice-daily regimen. Among the specific regimens examined, tenofovir/emtricitabine plus atazanavir/ritonavir showed the greatest durability.</description><subject>Adenine - administration & dosage</subject><subject>Adenine - analogs & derivatives</subject><subject>Anti-Retroviral Agents - administration & dosage</subject><subject>Antiretroviral drugs</subject><subject>Atazanavir Sulfate</subject><subject>Benzoxazines - administration & dosage</subject><subject>Cohort Studies</subject><subject>Comparative analysis</subject><subject>Deoxycytidine - administration & dosage</subject><subject>Deoxycytidine - analogs & derivatives</subject><subject>Drug Resistance, Viral - drug effects</subject><subject>Drug Resistance, Viral - physiology</subject><subject>Drug therapy</subject><subject>Drug Therapy, Combination</subject><subject>Emtricitabine</subject><subject>HIV</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - epidemiology</subject><subject>HIV-1 - drug effects</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Italy - epidemiology</subject><subject>Longitudinal Studies</subject><subject>Lopinavir - administration & dosage</subject><subject>Oligopeptides - administration & dosage</subject><subject>Organophosphonates - administration & dosage</subject><subject>Pharmacology</subject><subject>Prospective Studies</subject><subject>Pyridines - administration & dosage</subject><subject>Retrospective Studies</subject><subject>Ritonavir - administration & dosage</subject><subject>Tenofovir</subject><subject>Time Factors</subject><issn>0305-7453</issn><issn>1460-2091</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqN0V1rFDEUBuAgit1Wb_wBEvBGiuOefM3H5bKtWigIotfDmUyGzTqTrEmm0v4of2Mzbu1Fr7x6A3lywuEl5A2Djwwasd6jXvc_oxDNM7JisoSCQ8OekxUIUEUllTghpzHuAaBUZf2SnHDeMCVLsSJ_LuaAyXpH_UAHG2IqRusMRZdsMCn4GxtwpGlnAh5u6W-bdjQZ54flIquemikFq23Cbnmn_bRkf5SY8A4dZroONvm_pw_UDEsad0d9oKM_2CeCWrd8SK8SjhYd3XzbbvLgnQ_pFXkx4BjN64c8Iz8-XX7ffimuv36-2m6uCy1qmQpsQNa86xreVz0i1mUF2sBgDNa6GyTTtRi0EoJz1RnJK5C9Qg0cdF-WDMQZeX-cewj-12xiaicbtRlHdMbPsWW8VtBwJsT_UFHxBpjM9N0TuvdzcHmRrCQIVbKaZXV-VDr4GIMZ2kOwE4bblkG7FN7mwttj4Rm_fRg5d5PpH-m_hsU9sPKrQg</recordid><startdate>201301</startdate><enddate>201301</enddate><creator>Di Biagio, Antonio</creator><creator>Prinapori, Roberta</creator><creator>Giannarelli, Diana</creator><creator>Maggiolo, Franco</creator><creator>Di Giambenedetto, Simona</creator><creator>Borghi, Vanni</creator><creator>Penco, Giovanni</creator><creator>Cicconi, Paola</creator><creator>Francisci, Daniela</creator><creator>Sterrantino, Gaetana</creator><creator>Zoncada, Alessia</creator><creator>Monno, Laura</creator><creator>Capetti, Amedeo</creator><creator>Giacometti, Andrea</creator><general>Oxford Publishing Limited (England)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7QO</scope><scope>7T7</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>201301</creationdate><title>Duration of first-line antiretroviral therapy with tenofovir and emtricitabine combined with atazanavir/ritonavir, efavirenz or lopinavir/ritonavir in the Italian ARCA cohort</title><author>Di Biagio, Antonio ; Prinapori, Roberta ; Giannarelli, Diana ; Maggiolo, Franco ; Di Giambenedetto, Simona ; Borghi, Vanni ; Penco, Giovanni ; Cicconi, Paola ; Francisci, Daniela ; Sterrantino, Gaetana ; Zoncada, Alessia ; Monno, Laura ; Capetti, Amedeo ; Giacometti, Andrea</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384t-a90482bb92d7daaa8670ce0feea8cbf41c83fc533225be42704d5ac020cd66103</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adenine - 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Academic</collection><jtitle>Journal of antimicrobial chemotherapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Di Biagio, Antonio</au><au>Prinapori, Roberta</au><au>Giannarelli, Diana</au><au>Maggiolo, Franco</au><au>Di Giambenedetto, Simona</au><au>Borghi, Vanni</au><au>Penco, Giovanni</au><au>Cicconi, Paola</au><au>Francisci, Daniela</au><au>Sterrantino, Gaetana</au><au>Zoncada, Alessia</au><au>Monno, Laura</au><au>Capetti, Amedeo</au><au>Giacometti, Andrea</au><aucorp>ARCA Collaborative Group</aucorp><aucorp>on behalf of the ARCA Collaborative Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Duration of first-line antiretroviral therapy with tenofovir and emtricitabine combined with atazanavir/ritonavir, efavirenz or lopinavir/ritonavir in the Italian ARCA cohort</atitle><jtitle>Journal of antimicrobial chemotherapy</jtitle><addtitle>J Antimicrob Chemother</addtitle><date>2013-01</date><risdate>2013</risdate><volume>68</volume><issue>1</issue><spage>200</spage><epage>205</epage><pages>200-205</pages><issn>0305-7453</issn><eissn>1460-2091</eissn><abstract>To explore the durability of three first-line tenofovir/emtricitabine-based regimens in combination with atazanavir/ritonavir, efavirenz or lopinavir/ritonavir in HIV-1-infected patients.
A retrospective, longitudinal, multicentre analysis of adult patients enrolled in the Antiretroviral Resistance Cohort Analysis (ARCA), a national prospective observational cohort of HIV-1-infected patients followed up at more than 100 clinical and laboratory units in Italy. Patients eligible were those starting first-line antiretroviral therapy between 1 June 2004 and 15 April 2011 and who were followed up for at least 6 months. The primary endpoint was durability, defined as the time from antiretroviral therapy initiation to first treatment modification. Time-dependent events were analysed by the Kaplan-Meier approach and the Cox proportional hazard model.
There are 26,000 HIV-infected patients in the ARCA database, of whom 1654 met study inclusion criteria. Six hundred and thirty-nine (38.6%) received efavirenz, 321 (19.4%) received atazanavir/ritonavir and 694 (41.9%) received lopinavir/ritonavir as a first-line regimen. Over a total observation period of 88 months, equivalent to more than 2805 person-years of follow-up, 618 patients underwent treatment modification. Lopinavir/ritonavir, given twice daily, was associated with a higher discontinuation rate than efavirenz- and atazanavir-based regimens [hazard ratio (HR) 1.83, 95% confidence interval (CI) 1.56-2.15, P = 0.001]. Comparing the once-daily regimens, the rate of discontinuation of efavirenz was higher than that of atazanavir/ritonavir (HR 1.39, 95% CI 1.06-1.83, P = 0.016).
Significant differences in treatment duration were observed among the three studied regimens. Once-daily regimens exhibited greater durability than the twice-daily regimen. Among the specific regimens examined, tenofovir/emtricitabine plus atazanavir/ritonavir showed the greatest durability.</abstract><cop>England</cop><pub>Oxford Publishing Limited (England)</pub><pmid>22915463</pmid><doi>10.1093/jac/dks339</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0305-7453 |
| ispartof | Journal of antimicrobial chemotherapy, 2013-01, Vol.68 (1), p.200-205 |
| issn | 0305-7453 1460-2091 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1285092133 |
| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection; Free Full-Text Journals in Chemistry |
| subjects | Adenine - administration & dosage Adenine - analogs & derivatives Anti-Retroviral Agents - administration & dosage Antiretroviral drugs Atazanavir Sulfate Benzoxazines - administration & dosage Cohort Studies Comparative analysis Deoxycytidine - administration & dosage Deoxycytidine - analogs & derivatives Drug Resistance, Viral - drug effects Drug Resistance, Viral - physiology Drug therapy Drug Therapy, Combination Emtricitabine HIV HIV Infections - drug therapy HIV Infections - epidemiology HIV-1 - drug effects Human immunodeficiency virus Humans Italy - epidemiology Longitudinal Studies Lopinavir - administration & dosage Oligopeptides - administration & dosage Organophosphonates - administration & dosage Pharmacology Prospective Studies Pyridines - administration & dosage Retrospective Studies Ritonavir - administration & dosage Tenofovir Time Factors |
| title | Duration of first-line antiretroviral therapy with tenofovir and emtricitabine combined with atazanavir/ritonavir, efavirenz or lopinavir/ritonavir in the Italian ARCA cohort |
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