Virological suppression at 6 months is related to choice of initial regimen in antiretroviral-naive patients: a cohort study.

摘要: Background: Guidelines recommend both protease inhibitor (PI)- and non-nucleoside reverse transcriptase (NNRTI)-containing regimens for initial therapy in HIV-positive individuals whilst clinical trial data comparing treatment options remain limited.Objective: To assess whether drug selection (PI versus NNRTI) anti retroviral-naive patients is related to virological response at 6 months within a cohort.Design: Databases from two large clinics were used identify all treatment-naive initiating highly active antiretroviral (PI/ PI or NNRTI). Statistical models determined the likelihood of suppressing HIV viral load < 500 copies/ml, risk failure by months, factors associated with success.Results: Of 1109 potentially eligible 888 met study criteria included; 484 prescribed (40% indinavir, 41% nelfinavir) 404 NNRTI efavirenz, 60% nevirapine). Three arms compared: efavirenz nevirapine PI. After stratification year centre adjustment baseline variables, only group remained significantly suppression months. Patients on more likely achieve an undetectable than those nevirapine. The relative hazard was 0.77 (95% confidence interval, 0.61-0.96, P = 0.02) that 0.74 0.58-0.94, P=0.01), Efavirenz also performed better analysis months.Conclusion: Although observational cohort may be susceptible significant bias, this suggests compared either Clinical required confirm these findings. (C) 2002 Lippincott Williams Wilkins.