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A randomized trial of simplified maintenance therapy with abacavir, lamivudine, and zidovudine in human immunodeficiency virus infection

Publié dansThe Journal of infectious diseases, vol. 185, no. 9, p. 1251-1260
Date de publication2002
Résumé

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.

Mots-clés
  • Acquired Immunodeficiency Syndrome/ drug therapy/metabolism/virology
  • Anti-HIV Agents/ administration & dosage
  • Dideoxynucleosides/ administration & dosage
  • Drug Therapy, Combination
  • Female
  • Hiv-1
  • Humans
  • Lamivudine/ administration & dosage
  • Lipids/blood
  • Male
  • Prospective Studies
  • RNA, Viral/blood
  • Treatment Failure
  • Viral Load
  • Zidovudine/ administration & dosage
Citation (format ISO)
OPRAVIL, Milos et al. A randomized trial of simplified maintenance therapy with abacavir, lamivudine, and zidovudine in human immunodeficiency virus infection. In: The Journal of infectious diseases, 2002, vol. 185, n° 9, p. 1251–1260. doi: 10.1086/340312
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ISSN du journal0022-1899
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Première validation21/06/2010 10:25:33
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