Increased virological failure in naive HIV-1-infected patients taking lamivudine compared with emtricitabine in combination with tenofovir and efavirenz or nevirapine in the Dutch nationwide ATHENA cohort
© The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissionsoup.com..
BACKGROUND: Guidelines for treatment of human immunodeficiency virus type 1 (HIV-1) infection consider lamivudine and emtricitabine to be interchangeable components in first-line combination antiretroviral therapy (cART). The evidence for their clinical equivalence in cART is inconsistent. The primary aim of this study was to evaluate the virological responses to lamivudine and emtricitabine in recommended cART.
METHODS: This was an observational study using data from the AIDS Therapy Evaluation in the Netherlands (ATHENA) nationwide HIV cohort. The virological responses to lamivudine and emtricitabine were compared by multivariable adjusted logistic regression and Cox proportional hazard models. Sensitivity analyses included propensity score-adjusted models.
RESULTS: Therapy-naive HIV-1-infected patients without baseline resistance (N = 4740) initiated lamivudine or emtricitabine with efavirenz/tenofovir or nevirapine/tenofovir. The use of lamivudine was associated with more virological failure at week 48 compared to emtricitabine with efavirenz/tenofovir (10.8% vs 3.6%; adjusted odds ratio [AOR], 1.78; 95% confidence interval [CI], 1.11-2.84) and nevirapine/tenofovir (27% vs 11%; AOR, 2.09; 95% CI, 1.25-3.52) in on-treatment analysis. Propensity score-adjusted models and intent-to-treat sensitivity analyses gave comparable results. The adjusted hazard ratio of virological failure at week 240 using lamivudine instead of emtricitabine was 2.35 (95% CI, 1.61-3.42) with efavirenz and 2.01 (95% CI, 1.36-2.98) with nevirapine. The inclusion of lamivudine or emtricitabine in cART did not influence the time to virological suppression within 48 weeks or the probability of virological rebound after successful virological suppression.
CONCLUSIONS: The use of emtricitabine instead of lamivudine as part of cART was associated with better virological responses. These findings are relevant for settings with extensive use of lamivudine and for settings where generic lamivudine will be available.
| Errataetall: |
CommentIn: Clin Infect Dis. 2015 Jan 1;60(1):154-6. - PMID 25273083 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2015 |
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| Erschienen: |
2015 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:60 |
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| Enthalten in: |
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America - 60(2015), 1 vom: 01. Jan., Seite 143-53 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Rokx, Casper [VerfasserIn] |
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| Links: |
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| Themen: |
Anti-Retroviral Agents |
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| Anmerkungen: |
Date Completed 31.08.2015 Date Revised 08.04.2022 published: Print-Electronic CommentIn: Clin Infect Dis. 2015 Jan 1;60(1):154-6. - PMID 25273083 Citation Status MEDLINE |
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| doi: |
10.1093/cid/ciu763 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM242387004 |
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| 245 | 1 | 0 | |a Increased virological failure in naive HIV-1-infected patients taking lamivudine compared with emtricitabine in combination with tenofovir and efavirenz or nevirapine in the Dutch nationwide ATHENA cohort |
| 264 | 1 | |c 2015 | |
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| 500 | |a Date Completed 31.08.2015 | ||
| 500 | |a Date Revised 08.04.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: Clin Infect Dis. 2015 Jan 1;60(1):154-6. - PMID 25273083 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissionsoup.com. | ||
| 520 | |a BACKGROUND: Guidelines for treatment of human immunodeficiency virus type 1 (HIV-1) infection consider lamivudine and emtricitabine to be interchangeable components in first-line combination antiretroviral therapy (cART). The evidence for their clinical equivalence in cART is inconsistent. The primary aim of this study was to evaluate the virological responses to lamivudine and emtricitabine in recommended cART | ||
| 520 | |a METHODS: This was an observational study using data from the AIDS Therapy Evaluation in the Netherlands (ATHENA) nationwide HIV cohort. The virological responses to lamivudine and emtricitabine were compared by multivariable adjusted logistic regression and Cox proportional hazard models. Sensitivity analyses included propensity score-adjusted models | ||
| 520 | |a RESULTS: Therapy-naive HIV-1-infected patients without baseline resistance (N = 4740) initiated lamivudine or emtricitabine with efavirenz/tenofovir or nevirapine/tenofovir. The use of lamivudine was associated with more virological failure at week 48 compared to emtricitabine with efavirenz/tenofovir (10.8% vs 3.6%; adjusted odds ratio [AOR], 1.78; 95% confidence interval [CI], 1.11-2.84) and nevirapine/tenofovir (27% vs 11%; AOR, 2.09; 95% CI, 1.25-3.52) in on-treatment analysis. Propensity score-adjusted models and intent-to-treat sensitivity analyses gave comparable results. The adjusted hazard ratio of virological failure at week 240 using lamivudine instead of emtricitabine was 2.35 (95% CI, 1.61-3.42) with efavirenz and 2.01 (95% CI, 1.36-2.98) with nevirapine. The inclusion of lamivudine or emtricitabine in cART did not influence the time to virological suppression within 48 weeks or the probability of virological rebound after successful virological suppression | ||
| 520 | |a CONCLUSIONS: The use of emtricitabine instead of lamivudine as part of cART was associated with better virological responses. These findings are relevant for settings with extensive use of lamivudine and for settings where generic lamivudine will be available | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a HIV-1 | |
| 650 | 4 | |a antiretroviral therapy | |
| 650 | 4 | |a emtricitabine | |
| 650 | 4 | |a lamivudine | |
| 650 | 4 | |a virological failure | |
| 650 | 7 | |a Anti-Retroviral Agents |2 NLM | |
| 700 | 1 | |a Fibriani, Azzania |e verfasserin |4 aut | |
| 700 | 1 | |a van de Vijver, David A M C |e verfasserin |4 aut | |
| 700 | 1 | |a Verbon, Annelies |e verfasserin |4 aut | |
| 700 | 1 | |a Schutten, Martin |e verfasserin |4 aut | |
| 700 | 1 | |a Gras, Luuk |e verfasserin |4 aut | |
| 700 | 1 | |a Rijnders, Bart J A |e verfasserin |4 aut | |
| 700 | 0 | |a AIDS Therapy Evaluation in the Netherlands National Observational Cohort |e verfasserin |4 aut | |
| 700 | 1 | |a Prins, J M |e investigator |4 oth | |
| 700 | 1 | |a Kuijpers, T W |e investigator |4 oth | |
| 700 | 1 | |a Scherpbier, H J |e investigator |4 oth | |
| 700 | 1 | |a van der Meer, J T M |e investigator |4 oth | |
| 700 | 1 | |a Wit, F W M N |e investigator |4 oth | |
| 700 | 1 | |a Godfried, M H |e investigator |4 oth | |
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