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Ritonavir plus saquinavir versus single protease inhibitor therapy in protease inhibitor-naive HIV-infected patients: the Swiss HIV Cohort Study

Publié dansHIV medicine, vol. 3, no. 4, p. 247-253
Date de publication2002
Résumé

OBJECTIVES: To compare the response to ritonavir (RTV) plus saquinavir (SQV) with single protease inhibitor (PI) therapies among PI-naive HIV-1 infected individuals. METHODS: Response to treatment was analysed according to the intent-to-treat principle in a prospective observational cohort study of 177 patients who between May 1995 and March 2000 started a double PI therapy with RTV and SQV (nonboosting dosages) plus at least one nucleoside reverse transcriptase inhibitor (NRTI) and 2,214 patients with a single PI therapy plus two NRTIs. We used survival analysis and Cox's proportional hazard regression methods. The primary endpoint was the time to a plasma viral load of < 400 copies/mL. Secondary endpoints were taken as a gain in the CD4 count of >100 cells/microL, and change of initial PI for any reason. RESULTS: Baseline characteristics in both treatment groups were balanced. Median follow-up in both groups was 10.4 months. Time to an HIV-1 viral load of < 400 copies/mL and an increase in the CD4 count of >100 x 10(6) cells/L was shorter for RTV plus SQV compared with single PI regimens (log rank test for each endpoint P < 0.05). The adjusted hazard ratios of RTV plus SQV compared with single PI regimens were 1.21 (95% confidence interval 0.99-1.47) for achieving an HIV-1 viral load of < 400 copies/mL, 1.12 (0.88-1.42) for an increase in the CD4 count of > 100 cells/microL, and 0.90 (0.73-1.11) for change of first PI regimen. CONCLUSIONS: Treatment with RTV plus SQV compared with single PI regimens appeared to give similar results for virological or immunological response.

Mots-clés
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • CD4 Lymphocyte Count
  • Cohort Studies
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • HIV Infections/ drug therapy
  • HIV Protease Inhibitors/ administration & dosage
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • RNA, Viral/blood
  • Reverse Transcriptase Inhibitors/ administration & dosage
  • Ritonavir/ administration & dosage
  • Saquinavir/ administration & dosage
  • Viral Load
Citation (format ISO)
BUCHER, H. C. et al. Ritonavir plus saquinavir versus single protease inhibitor therapy in protease inhibitor-naive HIV-infected patients: the Swiss HIV Cohort Study. In: HIV medicine, 2002, vol. 3, n° 4, p. 247–253. doi: 10.1046/j.1468-1293.2002.00113.x
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ISSN du journal1464-2662
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