Early virological failure after tenofovir + didanosine + efavirenz combination in HIV-positive patients upon starting antiretroviral therapy

Carlo Torti, Eugenia Quiros-Roldan, Mario Regazzi, Andrea Antinori, Andrea Patroni, Paola Villani, Valeria Tirelli, Giuliana Cologni, Daniela Zinzi, Sergio Lo Caputo, Paolo Perini, Giampiero Carosi

Research output: Contribution to journalArticle

Abstract

A prospective, randomized pilot trial was conducted in naive patients comparing three different combinations: zidovudine+lamivudine+lopinavir/ ritonavir (arm A) versus tenofovir+lamivudine+efavirenz (arm B) versus tenofovir+didanosine+efavirenz (arm C). HIV-RNA slope (days 1, 3, 7, 14 and 28) was slower in arm C with respect to arm B (P0-24 values were lower in arm C with respect to arm B, especially in patients who failed early. A high virological failure rate after tenofovir+didanosine+efavirenz correlated with a slower HIV-RNA decrease and a peculiar accumulation of resistance mutations. A constellation of factors could be correlated with early failure events in patients receiving this combination such as resistance mutations or polymorphisms present at baseline, low CD4+ T-cell count or advanced disease and unexpectedly low efavirenz plasma levels.

Original languageEnglish
Pages (from-to)505-513
Number of pages9
JournalAntiviral Therapy
Volume10
Issue number4
Publication statusPublished - 2005

ASJC Scopus subject areas

  • Pharmacology

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    Torti, C., Quiros-Roldan, E., Regazzi, M., Antinori, A., Patroni, A., Villani, P., Tirelli, V., Cologni, G., Zinzi, D., Lo Caputo, S., Perini, P., & Carosi, G. (2005). Early virological failure after tenofovir + didanosine + efavirenz combination in HIV-positive patients upon starting antiretroviral therapy. Antiviral Therapy, 10(4), 505-513.