Switching to boosted protease inhibitor plus a second antiretroviral drug (dual therapy) for treatment simplification: A multicenter observational study

Alessandra Latini, Massimiliano Fabbiani, Vanni Borghi, Gaetana Sterrantino, Alberto Giannetti, Patrizia Lorenzini, Laura Loiacono, Adriana Ammassari, Rita Bellagamba, Manuela Colafigli, Gabriella D'Ettorre, Simona Di Giambenedetto, Andrea Antinori, Mauro Zaccarelli

Research output: Contribution to journalArticle

Abstract

Background: Aim of the study was to assess predictors of discontinuation/toxicity of boosted PI-based (PI/r) dual therapy (DT). Methods: Observational, retrospective switch study in patients successfully treated with triple drugs regimen. Patients switched to PI/r based DT [darunavir (DRV/r), lopinavir (LPV/r) or atazanavir (ATV/r)] plus a second drug: [raltegravir (RAL), maraviroc (MVC) etravirine (ETR), lamivudine (3TC) or tenofovir (TDF)] between 2009 and 2014 were included. The effect of each drug as well as other clinical and virological cofactors over treatment discontinuation (TD) was assessed using survival analysis. Results: Overall, 376 patients were included with mean follow-up of 73 weeks. The most commonly used drugs in DT were DRV/r (63.0 %) and RAL (53.7 %). TD was observed in 77 (20,4 %) patients: 38 (10,1 %) virological failure, 35 (9,3 %) toxicity/intolerance (4 deaths) and 4 (1 %) interruptions for patients decision. At Cox Model, adjusted by demographic and laboratory variables, DRV/r and ATV/r significantly reduced the likelihood of TD and longer treatment was associated with lower risk, while low CD4 count at baseline and number of previous regimens with a higher risk. Moreover, RAL and 3TC use were significantly associated with lower TD by toxicity. Conclusions: In our clinical practice experience, switching virologically suppressed patients to PI/r based DT showed adequate safety and efficacy, so that it may be used in selected patients with specific medical needs.

Original languageEnglish
Article number401
JournalBMC Infectious Diseases
Volume16
Issue number1
DOIs
Publication statusPublished - 2016

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Keywords

  • Antiretroviral therapy
  • Darunavir Atazanavir
  • Dual therapy
  • Raltegravir
  • Treatment simplification

ASJC Scopus subject areas

  • Infectious Diseases

Cite this

Latini, A., Fabbiani, M., Borghi, V., Sterrantino, G., Giannetti, A., Lorenzini, P., Loiacono, L., Ammassari, A., Bellagamba, R., Colafigli, M., D'Ettorre, G., Di Giambenedetto, S., Antinori, A., & Zaccarelli, M. (2016). Switching to boosted protease inhibitor plus a second antiretroviral drug (dual therapy) for treatment simplification: A multicenter observational study. BMC Infectious Diseases, 16(1), [401]. https://doi.org/10.1186/s12879-016-1703-z