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A Randomized Trial of Simplified Maintenance Therapy with Abacavir, Lamivudine, and Zidovudine in Human Immunodeficiency Virus Infection
Author(s) -
Milos Opravil,
Bernard Hirschel,
Adriano Lazzarin,
Hansjakob Furrer,
JeanPhilippe Chave,
Sabine Yerly,
Leslie R. Bisset,
Marek Fischer,
Pietro Vernazza,
Enos Bernasconi,
Manuel Battegay,
Bruno Ledergerber,
Huldrych F. Günthard,
Colin Howe,
Rainer Weber,
Luc Perrin
Publication year - 2002
Publication title -
the journal of infectious diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.69
H-Index - 252
eISSN - 1537-6613
pISSN - 0022-1899
DOI - 10.1086/340312
Subject(s) - zidovudine , lamivudine , abacavir , regimen , reverse transcriptase inhibitor , medicine , virology , tolerability , resistance mutation , adverse effect , reverse transcriptase , sida , biology , viral disease , virus , hepatitis b virus , polymerase chain reaction , biochemistry , gene
This randomized study evaluated the efficacy and tolerability of continued treatment with protease inhibitor plus nucleoside-analogue combination regimens (n=79) or a change to the simplified regimen of abacavir-lamivudine-zidovudine (n=84) in patients with suppressed human immunodeficiency virus type 1 (HIV-1) RNA for > or = 6 months who did not have the reverse transcriptase 215 mutation. After a median follow-up of 84 weeks, virologic failure was 6% in the continuation and 15% in the simplified group (P=.081). Previous zidovudine monotherapy or dual therapy and archived reverse transcriptase resistance mutations in HIV-1 DNA at baseline were significant predictors of failure. Study treatment was discontinued because of adverse events in 20% of the continuation and 7% of the simplified group (P=.021). Simplification to abacavir-lamivudine-zidovudine significantly decreased nonfasting cholesterol and triglyceride levels; however, this switch strategy carries a risk of virologic failure when treatment history or resistance testing suggest the presence of archived resistance mutations to the simplified regimen.

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