Open AccessEffectiveness and tolerability of abacavir‐lamivudine‐nevirapine (ABC/3TC/NVP) in a multicenter cohort of HIV‐infected ARV‐experienced patients
Author(s) -
Podzamczer D,
Ferrer E,
Llibre J,
Leal M,
Crusells M,
Knobel H,
Curto J,
Puig J,
Górgolas M,
GómezSirvent J,
Domingo P,
Rozas N,
LópezBernaldo de Quirós J,
Ocampo A,
Vergas J
Publication year - 2012
Publication title -
journal of the international aids society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.724
H-Index - 62
ISSN - 1758-2652
DOI - 10.7448/ias.15.6.18343
Subject(s) - medicine , abacavir , nevirapine , lamivudine , regimen , tolerability , cohort , viral load , human immunodeficiency virus (hiv) , gastroenterology , adverse effect , immunology , antiretroviral therapy , chronic hepatitis , virus
Purpose of the study Very scarce information has been published to date with the combination of ABC/3TC/NVP but it is currently being used in clinical practice in many centers in Spain. Our aim was to present the clinical experience with this regimen in a cohort of adult HIV‐infected pts. Methods Retrospective, multicenter, cohort study. Consecutive adult HIV‐infected ARV‐experienced pts, HLA‐B*5701‐negative, who started ABC/3TC/NVP between 2005–2010, with at least one follow‐up visit, were included. Demographic, clinical and laboratory variables were assessed at baseline, month 1, and every 3–4 months thereafter. The primary end point was HIV‐1 viral load (VL) <40 c/mL at 48 weeks. Data were analyzed by intent‐to‐treat (ITT) (non‐completer=failure) and on treatment (OT). Summary of results 227 pts were included and followed up for a median of 30 (0.5–76) months. 75 % male, 47 (24–83) years, 21% AIDS, 13% HCV+, baseline CD4 570 (32–1404) cells/µL and VL undetectable in 90% with a median of <1.59 (<1.59–5.1) log. Most pts were receiving NVP (63%), ABC (25%) or both (4%) in the previous regimen. ABC/3TC/NVP was initiated due to toxicity (42%), simplification (35%) or other reasons (22%) including to reduce drug cost. After 48 weeks, VL was <40 c/mL in 82% (ITT) and 94% (OT), and in 94% (OT) after 96 weeks. CD4 increased +63 (p<0.001) and +77 (p<0.001) cells/µL after 48 and 96 weeks, respectively. One or more drugs of the regimen were discontinued in 18% of pts during follow up: toxicity (7%), virologic failure (3%), lost to follow‐up (3%), unrelated death (0.4%) or other reasons (4%). No significant differences were observed in ALT, AST, or triglyceride changes during follow up. A significant increase of 7%, 10% and 14% was observed in total cholesterol, LDLc and HDLc, and a significant decrease in TC/HDL ratio (−5%, p=0.004) after 96 weeks, respectively. Conclusions In this particular cohort of ARV‐experienced pts previously receiving NVP or ABC, a combination of ABC/3TC/NVP was safe and mantained virologic suppression in the vast majority of pts, with rates similar to other switch strategies. A favourable lipid profile was observed after 96 weeks of follow up.