BACKGROUND: Triple nucleoside reverse-transcriptase inhibitors (NRTIs) are recommended by the World Health Organization as first-line regimen in treatment-naïve HIV-2-infected patients. However, ritonavir-boosted protease inhibitor (PI/r)-containing regimens are frequently prescribed. In the absence of previous randomized trials, we retrospectively compared these regimens in observational cohorts. METHODS: HIV-2-infected patients from 7 European cohorts who started triple NRTI or PI/r since January 1998 were included. Piecewise linear models were used to estimate CD4 cell count and plasma HIV-2 RNA level slopes, differentiating an early phase (until end of month 3) and a second phase (months 4-12). On-treatment analyses censored data at major treatment modification and systematically at month 12. RESULTS: Forty-four patients started triple NRTI therapy and 126 started PI/r therapy. Overall, the median CD4 cell count was 191 cells/mm(3) and the median plasma HIV-2 RNA level was ≥2.7 log(10) copies/ml in 61% of the patients at combination antiretroviral therapy (cART) initiation; the median duration of the first cART was 20 months, not differing between groups. PI/r regimens were associated with better CD4 cell count and HIV-2 RNA level outcomes, compared with NRTI regimens. Estimated CD4 cell count slopes were +6 and +12 cells/mm(3)/month during the early phase (P = .22), and -60 cells/mm(3)/year versus +76 cells/mm(3)/year during the second phase (P = .002), for triple NRTI and PI/r, respectively. Estimated mean HIV-2 RNA levels at month 12 in patients with detectable viremia at cART initiation were 4.0 and 2.2 log(10) copies/ml, respectively (P = .005). CONCLUSIONS: In this observational study, PI/r-containing regimens showed superior efficacy over triple NRTI regimens as first-line therapy in HIV-2-infected patients.
BACKGROUND: Triple nucleoside reverse-transcriptase inhibitors (NRTIs) are recommended by the World Health Organization as first-line regimen in treatment-naïve HIV-2-infectedpatients. However, ritonavir-boosted protease inhibitor (PI/r)-containing regimens are frequently prescribed. In the absence of previous randomized trials, we retrospectively compared these regimens in observational cohorts. METHODS:HIV-2-infectedpatients from 7 European cohorts who started triple NRTI or PI/r since January 1998 were included. Piecewise linear models were used to estimate CD4 cell count and plasma HIV-2 RNA level slopes, differentiating an early phase (until end of month 3) and a second phase (months 4-12). On-treatment analyses censored data at major treatment modification and systematically at month 12. RESULTS: Forty-four patients started triple NRTI therapy and 126 started PI/r therapy. Overall, the median CD4 cell count was 191 cells/mm(3) and the median plasma HIV-2 RNA level was ≥2.7 log(10) copies/ml in 61% of the patients at combination antiretroviral therapy (cART) initiation; the median duration of the first cART was 20 months, not differing between groups. PI/r regimens were associated with better CD4 cell count and HIV-2 RNA level outcomes, compared with NRTI regimens. Estimated CD4 cell count slopes were +6 and +12 cells/mm(3)/month during the early phase (P = .22), and -60 cells/mm(3)/year versus +76 cells/mm(3)/year during the second phase (P = .002), for triple NRTI and PI/r, respectively. Estimated mean HIV-2 RNA levels at month 12 in patients with detectable viremia at cART initiation were 4.0 and 2.2 log(10) copies/ml, respectively (P = .005). CONCLUSIONS: In this observational study, PI/r-containing regimens showed superior efficacy over triple NRTI regimens as first-line therapy in HIV-2-infectedpatients.
Authors: Selly Ba; Dana N Raugi; Robert A Smith; Fatima Sall; Khadim Faye; Stephen E Hawes; Papa Salif Sow; Moussa Seydi; Geoffrey S Gottlieb Journal: Clin Infect Dis Date: 2018-10-30 Impact factor: 9.079
Authors: Robert A Smith; Dana N Raugi; Charlotte Pan; Matthew Coyne; Alexandra Hernandez; Brad Church; Kara Parker; James I Mullins; Papa Salif Sow; Geoffrey S Gottlieb Journal: PLoS One Date: 2012-09-18 Impact factor: 3.240
Authors: Dana N Raugi; Selly Ba; Ousseynou Cisse; Khardiata Diallo; Ibrahima Tito Tamba; Cheikh Ndour; Ndeye Mery Dia Badiane; Louise Fortes; Mouhamadou Baïla Diallo; Dominique Faye; Robert A Smith; Fatima Sall; Macoumba Toure; ElHadji Ibrahima Sall; Habibatou Diallo Agne; Khadim Faye; Jean Philippe Diatta; Marie Pierre Sy; Ming Chang; Binetou Diaw; Jacques Sambou; Raphael Bakhoum; Mame Demba Sy; Alassane Niang; Jean Jacques Malomar; Robert W Coombs; Stephen E Hawes; Ibra Ndoye; Nancy B Kiviat; Papa Salif Sow; Moussa Seydi; Geoffrey S Gottlieb Journal: Clin Infect Dis Date: 2021-02-01 Impact factor: 20.999
Authors: Robert A Smith; Dana N Raugi; Charlotte Pan; Papa Salif Sow; Moussa Seydi; James I Mullins; Geoffrey S Gottlieb Journal: Retrovirology Date: 2015-02-05 Impact factor: 4.602