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

Milos Opravil, Bernard Hirschel, Adriano Lazzarin, Hansjakob Furrer, Jean Philippe Chave, Sabine Yerly, Leslie R. Bisset, Marek Fischer, Pietro Vernazza, Enos Bernasconi, Manuel Battegay, Bruno Ledergerber, Huldrych Günthard, Colin Howe, Rainer Weber, Luc Perrin

Research output: Contribution to journalArticle

Abstract

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 ≥ 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.

Original languageEnglish
Pages (from-to)1251-1260
Number of pages10
JournalJournal of Infectious Diseases
Volume185
Issue number9
DOIs
Publication statusPublished - May 1 2002

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Zidovudine
Virus Diseases
RNA-Directed DNA Polymerase
HIV
Mutation
HIV-1
Protease Inhibitors
Treatment Failure
Nucleosides
Triglycerides
Therapeutics
History
Cholesterol
RNA
DNA
lamivudine drug combination abacavir

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Immunology

Cite this

A randomized trial of simplified maintenance therapy with abacavir, lamivudine, and zidovudine in human immunodeficiency virus infection. / Opravil, Milos; Hirschel, Bernard; Lazzarin, Adriano; Furrer, Hansjakob; Chave, Jean Philippe; Yerly, Sabine; Bisset, Leslie R.; Fischer, Marek; Vernazza, Pietro; Bernasconi, Enos; Battegay, Manuel; Ledergerber, Bruno; Günthard, Huldrych; Howe, Colin; Weber, Rainer; Perrin, Luc.

In: Journal of Infectious Diseases, Vol. 185, No. 9, 01.05.2002, p. 1251-1260.

Research output: Contribution to journalArticle

Opravil, M, Hirschel, B, Lazzarin, A, Furrer, H, Chave, JP, Yerly, S, Bisset, LR, Fischer, M, Vernazza, P, Bernasconi, E, Battegay, M, Ledergerber, B, Günthard, H, Howe, C, Weber, R & Perrin, L 2002, 'A randomized trial of simplified maintenance therapy with abacavir, lamivudine, and zidovudine in human immunodeficiency virus infection', Journal of Infectious Diseases, vol. 185, no. 9, pp. 1251-1260. https://doi.org/10.1086/340312
Opravil, Milos ; Hirschel, Bernard ; Lazzarin, Adriano ; Furrer, Hansjakob ; Chave, Jean Philippe ; Yerly, Sabine ; Bisset, Leslie R. ; Fischer, Marek ; Vernazza, Pietro ; Bernasconi, Enos ; Battegay, Manuel ; Ledergerber, Bruno ; Günthard, Huldrych ; Howe, Colin ; Weber, Rainer ; Perrin, Luc. / A randomized trial of simplified maintenance therapy with abacavir, lamivudine, and zidovudine in human immunodeficiency virus infection. In: Journal of Infectious Diseases. 2002 ; Vol. 185, No. 9. pp. 1251-1260.
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