BACKGROUND: Effectiveness of antiretroviral therapy (ART) in a routine clinical care may result different from the clinical trials. We assessed the virologic outcomes in treatment-naive persons who received either efavirenz (EFV) or atazanavir/ritonavir (ATV/r) with a backbone of tenofovir/emtricitabine (TDF/FTC) as their combination ART (cART). METHODS: This was a retrospective cohort study conducted at the Washington University HIV Outpatient Clinic from January 2004 to June 2009. Predictors of virologic suppression (HIV RNA level <400 copies/mL) by week 48 were assessed by multivariate Cox proportional hazards regression models. RESULTS: Of 324 persons, 221(68%) received EFV and 103 (32%) received ATV/r. Persons on EFV had 1.4-fold increased likelihood of virologic suppression (95% confidence interval, 1.0-1.8) when compared to ATV/r after adjustment with primary drug resistance, pre-cART opportunistic infection, HIV RNA levels, and timing to start cART. CONCLUSIONS: In routine clinical care settings, EFV had higher likelihood of achieving virologic suppression than ATV/r with backbone of TDF/FTC.
BACKGROUND: Effectiveness of antiretroviral therapy (ART) in a routine clinical care may result different from the clinical trials. We assessed the virologic outcomes in treatment-naive persons who received either efavirenz (EFV) or atazanavir/ritonavir (ATV/r) with a backbone of tenofovir/emtricitabine (TDF/FTC) as their combination ART (cART). METHODS: This was a retrospective cohort study conducted at the Washington University HIV Outpatient Clinic from January 2004 to June 2009. Predictors of virologic suppression (HIV RNA level <400 copies/mL) by week 48 were assessed by multivariate Cox proportional hazards regression models. RESULTS: Of 324 persons, 221(68%) received EFV and 103 (32%) received ATV/r. Persons on EFV had 1.4-fold increased likelihood of virologic suppression (95% confidence interval, 1.0-1.8) when compared to ATV/r after adjustment with primary drug resistance, pre-cART opportunistic infection, HIV RNA levels, and timing to start cART. CONCLUSIONS: In routine clinical care settings, EFV had higher likelihood of achieving virologic suppression than ATV/r with backbone of TDF/FTC.
Authors: Sandra W Cardoso; Paula M Luz; Luciane Velasque; Thiago Torres; Lara Coelho; Kenneth A Freedberg; Valdilea G Veloso; Rochelle P Walensky; Beatriz Grinsztejn Journal: AIDS Res Ther Date: 2014-09-01 Impact factor: 2.250
Authors: Lauren E Cain; Ellen C Caniglia; Andrew Phillips; Ashley Olson; Roberto Muga; Santiago Pérez-Hoyos; Sophie Abgrall; Dominique Costagliola; Rafael Rubio; Inma Jarrín; Heiner Bucher; Jan Fehr; Ard van Sighem; Peter Reiss; François Dabis; Marie-Anne Vandenhende; Roger Logan; James Robins; Jonathan A C Sterne; Amy Justice; Janet Tate; Giota Touloumi; Vasilis Paparizos; Anna Esteve; Jordi Casabona; Rémonie Seng; Laurence Meyer; Sophie Jose; Caroline Sabin; Miguel A Hernán Journal: Medicine (Baltimore) Date: 2016-10 Impact factor: 1.889