Predictors of Loss of Virologic Response in Subjects Who Simplified to Lopinavir/Ritonavir Monotherapy from Lopinavir/Ritonavir Plus Zidovudine/Lamivudine
Previous studies have demonstrated that lopinavir/ritonavir monotherapy maintained plasma HIV-1 RNA suppression in a large proportion of antiretroviral naive subjects. However, more subjects receiving lopinavir/ritonavir monotherapy experienced confirmed virologic rebound >50 copies/ml compared t...
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| Veröffentlicht in: | AIDS research and human retroviruses 2009-03, Vol.25 (3), p.269-275 |
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| creator | CAMPO, Rafael E DA SILVA, Barbara A COTTE, Laurent GATHE, Joseph C GAZZARD, Brian HICKS, Charles B KLEIN, Cheri E CHIU, Yi-Lin KING, Martin S BERNSTEIN, Barry M |
| description | Previous studies have demonstrated that lopinavir/ritonavir monotherapy maintained plasma HIV-1 RNA suppression in a large proportion of antiretroviral naive subjects. However, more subjects receiving lopinavir/ritonavir monotherapy experienced confirmed virologic rebound >50 copies/ml compared to a standard three-drug HAART regimen. In this study, we sought to determine the factors associated with maintenance of virologic suppression in subjects receiving lopinavir/ritonavir monotherapy. Antiretroviral-naive HIV-1-infected volunteers were randomized 2:1 to initiate a lopinavir/ritonavir-based combination regimen followed by simplification to lopinavir/ritonavir monotherapy or an efavirenz-based triple combination therapy and followed for 96 weeks. Potential predictors of time to loss of virologic response included baseline demographics, baseline HIV-1 RNA levels, baseline CD4(+) T cell counts, adherence as determined by 4-day subject recall, duration of HIV-1 RNA |
| doi_str_mv | 10.1089/aid.2008.0217 |
| format | Article |
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However, more subjects receiving lopinavir/ritonavir monotherapy experienced confirmed virologic rebound >50 copies/ml compared to a standard three-drug HAART regimen. In this study, we sought to determine the factors associated with maintenance of virologic suppression in subjects receiving lopinavir/ritonavir monotherapy. Antiretroviral-naive HIV-1-infected volunteers were randomized 2:1 to initiate a lopinavir/ritonavir-based combination regimen followed by simplification to lopinavir/ritonavir monotherapy or an efavirenz-based triple combination therapy and followed for 96 weeks. Potential predictors of time to loss of virologic response included baseline demographics, baseline HIV-1 RNA levels, baseline CD4(+) T cell counts, adherence as determined by 4-day subject recall, duration of HIV-1 RNA <50 copies/ml prior to simplification, and lopinavir concentrations. By the Cox proportional hazards model, higher reported adherence levels and higher baseline CD4(+) T cell counts were associated with a greater likelihood of maintaining virologic suppression while receiving lopinavir/ritonavir monotherapy. Lopinavir concentrations, including trough concentrations, were not significantly associated with virologic outcomes. This analysis suggests that adherence and higher baseline CD4(+) T cell counts may help to predict who will sustain virologic suppression with lopinavir/ritonavir monotherapy. The data also suggest that measuring lopinavir concentrations is not useful in predicting virologic response in these patients.</description><identifier>ISSN: 0889-2229</identifier><identifier>EISSN: 1931-8405</identifier><identifier>DOI: 10.1089/aid.2008.0217</identifier><identifier>PMID: 19292590</identifier><identifier>CODEN: ARHRE7</identifier><language>eng</language><publisher>New Rochelle, NY: Liebert</publisher><subject>AIDS/HIV ; Anti-HIV agents ; Anti-HIV Agents - therapeutic use ; Antiretroviral Therapy, Highly Active - methods ; Antiviral agents ; Biological and medical sciences ; CD4 Lymphocyte Count ; Complications and side effects ; Dosage and administration ; Drug therapy ; Drug therapy, Combination ; Fundamental and applied biological sciences. Psychology ; Health aspects ; HIV infection ; HIV Infections - drug therapy ; HIV Infections - immunology ; HIV Infections - virology ; HIV-1 - drug effects ; Human immunodeficiency virus 1 ; Human viral diseases ; Humans ; Infectious diseases ; Lamivudine - therapeutic use ; Lopinavir ; Medical sciences ; Medication Adherence - statistics & numerical data ; Microbiology ; Miscellaneous ; Plasma - chemistry ; Pyrimidinones - blood ; Pyrimidinones - therapeutic use ; Retrovirus ; Ritonavir - therapeutic use ; Time Factors ; Treatment Outcome ; Viral diseases ; Viral Load ; Virology ; Zidovudine - therapeutic use</subject><ispartof>AIDS research and human retroviruses, 2009-03, Vol.25 (3), p.269-275</ispartof><rights>2009 INIST-CNRS</rights><rights>COPYRIGHT 2009 Mary Ann Liebert, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c419t-c0844eb8ef0f009e6c7796a0a80cf2ef03ca8ef1079772da40c39ac01b343f393</citedby><cites>FETCH-LOGICAL-c419t-c0844eb8ef0f009e6c7796a0a80cf2ef03ca8ef1079772da40c39ac01b343f393</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,3029,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21376674$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19292590$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>CAMPO, Rafael E</creatorcontrib><creatorcontrib>DA SILVA, Barbara A</creatorcontrib><creatorcontrib>COTTE, Laurent</creatorcontrib><creatorcontrib>GATHE, Joseph C</creatorcontrib><creatorcontrib>GAZZARD, Brian</creatorcontrib><creatorcontrib>HICKS, Charles B</creatorcontrib><creatorcontrib>KLEIN, Cheri E</creatorcontrib><creatorcontrib>CHIU, Yi-Lin</creatorcontrib><creatorcontrib>KING, Martin S</creatorcontrib><creatorcontrib>BERNSTEIN, Barry M</creatorcontrib><title>Predictors of Loss of Virologic Response in Subjects Who Simplified to Lopinavir/Ritonavir Monotherapy from Lopinavir/Ritonavir Plus Zidovudine/Lamivudine</title><title>AIDS research and human retroviruses</title><addtitle>AIDS Res Hum Retroviruses</addtitle><description>Previous studies have demonstrated that lopinavir/ritonavir monotherapy maintained plasma HIV-1 RNA suppression in a large proportion of antiretroviral naive subjects. However, more subjects receiving lopinavir/ritonavir monotherapy experienced confirmed virologic rebound >50 copies/ml compared to a standard three-drug HAART regimen. In this study, we sought to determine the factors associated with maintenance of virologic suppression in subjects receiving lopinavir/ritonavir monotherapy. Antiretroviral-naive HIV-1-infected volunteers were randomized 2:1 to initiate a lopinavir/ritonavir-based combination regimen followed by simplification to lopinavir/ritonavir monotherapy or an efavirenz-based triple combination therapy and followed for 96 weeks. Potential predictors of time to loss of virologic response included baseline demographics, baseline HIV-1 RNA levels, baseline CD4(+) T cell counts, adherence as determined by 4-day subject recall, duration of HIV-1 RNA <50 copies/ml prior to simplification, and lopinavir concentrations. By the Cox proportional hazards model, higher reported adherence levels and higher baseline CD4(+) T cell counts were associated with a greater likelihood of maintaining virologic suppression while receiving lopinavir/ritonavir monotherapy. Lopinavir concentrations, including trough concentrations, were not significantly associated with virologic outcomes. This analysis suggests that adherence and higher baseline CD4(+) T cell counts may help to predict who will sustain virologic suppression with lopinavir/ritonavir monotherapy. The data also suggest that measuring lopinavir concentrations is not useful in predicting virologic response in these patients.</description><subject>AIDS/HIV</subject><subject>Anti-HIV agents</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Antiretroviral Therapy, Highly Active - methods</subject><subject>Antiviral agents</subject><subject>Biological and medical sciences</subject><subject>CD4 Lymphocyte Count</subject><subject>Complications and side effects</subject><subject>Dosage and administration</subject><subject>Drug therapy</subject><subject>Drug therapy, Combination</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Health aspects</subject><subject>HIV infection</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - immunology</subject><subject>HIV Infections - virology</subject><subject>HIV-1 - drug effects</subject><subject>Human immunodeficiency virus 1</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Lamivudine - therapeutic use</subject><subject>Lopinavir</subject><subject>Medical sciences</subject><subject>Medication Adherence - statistics & numerical data</subject><subject>Microbiology</subject><subject>Miscellaneous</subject><subject>Plasma - chemistry</subject><subject>Pyrimidinones - blood</subject><subject>Pyrimidinones - therapeutic use</subject><subject>Retrovirus</subject><subject>Ritonavir - therapeutic use</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Viral diseases</subject><subject>Viral Load</subject><subject>Virology</subject><subject>Zidovudine - therapeutic use</subject><issn>0889-2229</issn><issn>1931-8405</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkk1r3DAQhkVpabZJj70WQWlv3h1JtmUdQ-gXbGhI-gG9CK0sJRNsy5HsQP5Kf2212SWlEAhzmGHmeQeJeQl5w2DJoFErg-2SAzRL4Ew-IwumBCuaEqrnZAFNowrOuTogr1K6BgDFefWSHDDFFa8ULMifs-hatFOIiQZP1yHd558YQxcu0dJzl8YwJEdxoBfz5trZKdFfV4FeYD926NG1dApZOOJgbjGuznEK9xU9DUOYrlw04x31MfSPQmfdnOhvbMPt3OLgVmvT4648Ii-86ZJ7vc-H5Menj99PvhTrb5-_nhyvC1syNRUWmrJ0m8Z58PmDrrZSqtqAacB6nrvCmjxkIJWUvDUlWKGMBbYRpfBCiUPyYbd3jOFmdmnSPSbrus4MLsxJ1xKailfsSZBDJXgtZAbf7cBL0zmNgw9TNHYL62OmmpKVooZMLR-hcrSuRxsG5zH3_xMUO4GN-UzReT1G7E280wz01gw6m0FvzaC3Zsj82_17503v2n_0_voZeL8HTLKm89EMFtMDx5mQdS1L8RdlkL6X</recordid><startdate>20090301</startdate><enddate>20090301</enddate><creator>CAMPO, Rafael E</creator><creator>DA SILVA, Barbara A</creator><creator>COTTE, Laurent</creator><creator>GATHE, Joseph C</creator><creator>GAZZARD, Brian</creator><creator>HICKS, Charles B</creator><creator>KLEIN, Cheri E</creator><creator>CHIU, Yi-Lin</creator><creator>KING, Martin S</creator><creator>BERNSTEIN, Barry M</creator><general>Liebert</general><general>Mary Ann Liebert, Inc</general><scope>IQODW</scope><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>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>20090301</creationdate><title>Predictors of Loss of Virologic Response in Subjects Who Simplified to Lopinavir/Ritonavir Monotherapy from Lopinavir/Ritonavir Plus Zidovudine/Lamivudine</title><author>CAMPO, Rafael E ; DA SILVA, Barbara A ; COTTE, Laurent ; GATHE, Joseph C ; GAZZARD, Brian ; HICKS, Charles B ; KLEIN, Cheri E ; CHIU, Yi-Lin ; KING, Martin S ; BERNSTEIN, Barry M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c419t-c0844eb8ef0f009e6c7796a0a80cf2ef03ca8ef1079772da40c39ac01b343f393</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>AIDS/HIV</topic><topic>Anti-HIV agents</topic><topic>Anti-HIV Agents - therapeutic use</topic><topic>Antiretroviral Therapy, Highly Active - methods</topic><topic>Antiviral agents</topic><topic>Biological and medical sciences</topic><topic>CD4 Lymphocyte Count</topic><topic>Complications and side effects</topic><topic>Dosage and administration</topic><topic>Drug therapy</topic><topic>Drug therapy, Combination</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Health aspects</topic><topic>HIV infection</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - immunology</topic><topic>HIV Infections - virology</topic><topic>HIV-1 - drug effects</topic><topic>Human immunodeficiency virus 1</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Lamivudine - therapeutic use</topic><topic>Lopinavir</topic><topic>Medical sciences</topic><topic>Medication Adherence - statistics & numerical data</topic><topic>Microbiology</topic><topic>Miscellaneous</topic><topic>Plasma - chemistry</topic><topic>Pyrimidinones - blood</topic><topic>Pyrimidinones - therapeutic use</topic><topic>Retrovirus</topic><topic>Ritonavir - therapeutic use</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Viral diseases</topic><topic>Viral Load</topic><topic>Virology</topic><topic>Zidovudine - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>CAMPO, Rafael E</creatorcontrib><creatorcontrib>DA SILVA, Barbara A</creatorcontrib><creatorcontrib>COTTE, Laurent</creatorcontrib><creatorcontrib>GATHE, Joseph C</creatorcontrib><creatorcontrib>GAZZARD, Brian</creatorcontrib><creatorcontrib>HICKS, Charles B</creatorcontrib><creatorcontrib>KLEIN, Cheri E</creatorcontrib><creatorcontrib>CHIU, Yi-Lin</creatorcontrib><creatorcontrib>KING, Martin S</creatorcontrib><creatorcontrib>BERNSTEIN, Barry M</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>AIDS research and human retroviruses</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>CAMPO, Rafael E</au><au>DA SILVA, Barbara A</au><au>COTTE, Laurent</au><au>GATHE, Joseph C</au><au>GAZZARD, Brian</au><au>HICKS, Charles B</au><au>KLEIN, Cheri E</au><au>CHIU, Yi-Lin</au><au>KING, Martin S</au><au>BERNSTEIN, Barry M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors of Loss of Virologic Response in Subjects Who Simplified to Lopinavir/Ritonavir Monotherapy from Lopinavir/Ritonavir Plus Zidovudine/Lamivudine</atitle><jtitle>AIDS research and human retroviruses</jtitle><addtitle>AIDS Res Hum Retroviruses</addtitle><date>2009-03-01</date><risdate>2009</risdate><volume>25</volume><issue>3</issue><spage>269</spage><epage>275</epage><pages>269-275</pages><issn>0889-2229</issn><eissn>1931-8405</eissn><coden>ARHRE7</coden><abstract>Previous studies have demonstrated that lopinavir/ritonavir monotherapy maintained plasma HIV-1 RNA suppression in a large proportion of antiretroviral naive subjects. However, more subjects receiving lopinavir/ritonavir monotherapy experienced confirmed virologic rebound >50 copies/ml compared to a standard three-drug HAART regimen. In this study, we sought to determine the factors associated with maintenance of virologic suppression in subjects receiving lopinavir/ritonavir monotherapy. Antiretroviral-naive HIV-1-infected volunteers were randomized 2:1 to initiate a lopinavir/ritonavir-based combination regimen followed by simplification to lopinavir/ritonavir monotherapy or an efavirenz-based triple combination therapy and followed for 96 weeks. Potential predictors of time to loss of virologic response included baseline demographics, baseline HIV-1 RNA levels, baseline CD4(+) T cell counts, adherence as determined by 4-day subject recall, duration of HIV-1 RNA <50 copies/ml prior to simplification, and lopinavir concentrations. By the Cox proportional hazards model, higher reported adherence levels and higher baseline CD4(+) T cell counts were associated with a greater likelihood of maintaining virologic suppression while receiving lopinavir/ritonavir monotherapy. Lopinavir concentrations, including trough concentrations, were not significantly associated with virologic outcomes. This analysis suggests that adherence and higher baseline CD4(+) T cell counts may help to predict who will sustain virologic suppression with lopinavir/ritonavir monotherapy. The data also suggest that measuring lopinavir concentrations is not useful in predicting virologic response in these patients.</abstract><cop>New Rochelle, NY</cop><pub>Liebert</pub><pmid>19292590</pmid><doi>10.1089/aid.2008.0217</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0889-2229 |
| ispartof | AIDS research and human retroviruses, 2009-03, Vol.25 (3), p.269-275 |
| issn | 0889-2229 1931-8405 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_67085251 |
| source | Mary Ann Liebert Online Subscription; MEDLINE; Alma/SFX Local Collection |
| subjects | AIDS/HIV Anti-HIV agents Anti-HIV Agents - therapeutic use Antiretroviral Therapy, Highly Active - methods Antiviral agents Biological and medical sciences CD4 Lymphocyte Count Complications and side effects Dosage and administration Drug therapy Drug therapy, Combination Fundamental and applied biological sciences. Psychology Health aspects HIV infection HIV Infections - drug therapy HIV Infections - immunology HIV Infections - virology HIV-1 - drug effects Human immunodeficiency virus 1 Human viral diseases Humans Infectious diseases Lamivudine - therapeutic use Lopinavir Medical sciences Medication Adherence - statistics & numerical data Microbiology Miscellaneous Plasma - chemistry Pyrimidinones - blood Pyrimidinones - therapeutic use Retrovirus Ritonavir - therapeutic use Time Factors Treatment Outcome Viral diseases Viral Load Virology Zidovudine - therapeutic use |
| title | Predictors of Loss of Virologic Response in Subjects Who Simplified to Lopinavir/Ritonavir Monotherapy from Lopinavir/Ritonavir Plus Zidovudine/Lamivudine |
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