Despite the relative lack of data, nucleoside/nucleotide reverse transcriptase inhibitor (NRTI)-sparing regimens are increasingly prescribed in clinical practice in treatment-experienced HIV-1 infected patients. We aimed to assess the frequency of NRTI-sparing regimens among these subjects, and to evaluate and compare their safety and tolerability. Patients were included if enrolled in the currently ongoing cohorts (raltegravir and darunavir) of the Surveillance Cohort Long-Term Toxicity Antiretrovirals (SCOLTA) Project. The duration of treatment with antiretroviral therapy was evaluated using the Kaplan-Meier curve and NRTI-sparing and NRTI-based regimens were compared using the log-rank test. From 2006 to 2011, 689 experienced patients were analyzed, of whom 210 (30.5%) were on NRTI-sparing regimens. Patients on NRTI-sparing regimens were older (p=0.004) and had higher median CD4+ cell counts (p=0.002) than patients on NRTI-based regimens. The most frequent combination regimens were raltegravir plus darunavir/ritonavir (n=65; 30.95%) among patients on NRTI-sparing regimen and tenofovir DF/emtricitabine plus darunavir/ritonavir in the NRTI-containing group (n=102; 21.3%). There was no difference between groups in terms of total withdrawal, treatment discontinuation was more likely due to therapeutic failure in NRTI-sparing regimen. NRTI-sparing regimens should be evaluated in a prospective randomized trial.

Download full-text PDF

Source
http://dx.doi.org/10.2174/1570162x113119990036DOI Listing

Publication Analysis

Top Keywords

nrti-sparing regimens
20
regimens
9
reverse transcriptase
8
treatment-experienced hiv-1
8
hiv-1 infected
8
infected patients
8
nrti-sparing
8
nrti-based regimens
8
patients nrti-sparing
8
nrti-sparing regimen
8

Similar Publications

Background: HIV clinical practice guidelines outline broad treatment principles but offer less explicit recommendations by permutations of encountered viral resistance. We hypothesize that there is variability in antiretroviral (ARV) regimen decision making among providers when considering HIV drug resistance (HIVDR).

Methods: US HIV providers provided ARV regimen recommendations for case vignettes in a series of electronic surveys encompassing variations of HIVDR.

View Article and Find Full Text PDF
Article Synopsis
  • The SMILE trial investigated the effectiveness and safety of switching children living with HIV to a treatment regimen of integrase inhibitor (INSTI) and boosted darunavir (DRV/r), compared to continuing standard triple antiretroviral therapy (SOC).
  • The trial enrolled 318 participants aged 6-18 from multiple regions, finding that switching to the new regimen showed non-inferiority in maintaining low HIV-RNA levels after 48 weeks.
  • The results indicated no significant differences in safety between the two groups, but the INSTI + DRV/r group had greater increases in weight and BMI compared to those on SOC.
View Article and Find Full Text PDF

Objectives: Because NRTIs can have fetal toxicities, we evaluated a perinatal NRTI-sparing strategy to prevent perinatal HIV transmission. Our primary objective was to determine the proportion maintaining a viral load (VL) of <50 copies/mL up to delivery on darunavir/ritonavir monotherapy, without requiring treatment intensification.

Methods: In a one-arm, multicentre Phase 2 clinical trial, eligible patients in the first trimester of pregnancy on ART with plasma VL < 50 copies/mL received maintenance monotherapy with darunavir/ritonavir, 600/100 mg twice daily.

View Article and Find Full Text PDF
Article Synopsis
  • A significant change in the availability of antiretroviral therapies has allowed researchers to assess new second-line treatments for HIV-1 in low- and middle-income countries through the DEFT trial.
  • The DEFT trial, initiated in 2017, compares a standard regimen of boosted darunavir with NRTIs to a newer NRTI-sparing regimen with boosted darunavir and dolutegravir.
  • Arising from recent updates in treatment guidelines, the study decided to incorporate the evaluation of the TLD regimen as a third arm, instead of starting a new trial, to optimize resources and streamline recruitment.
View Article and Find Full Text PDF
Article Synopsis
  • The study explores the characteristics and treatment patterns of people living with HIV-1 (PLWH) in Japan who are on 2-drug antiretroviral therapy (2-ART) compared to those on standard 3-drug therapy (3-ART).
  • Data from a large medical claim database covering 4,293 PLWH revealed that the 2-ART cohort was older, had more comorbidities and co-medications, and a higher percentage of AIDS-defining conditions compared to the 3-ART group.
  • Treatment switching was more frequent in the 2-ART cohort (33.0%) compared to 3-ART (21.2%), with a majority of the 2-ART
View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!