Poster Abstract
P290
Effectiveness and tolerability of abacavir-lamivudine-nevirapine
(ABC/3TC/NVP) in a multicenter cohort of HIV-infected
ARV-experienced patients
Podzamczer, D1; Ferrer, E1; Llibre, J2; Leal, M3; Crusells, M4; Knobel, H5; Curto, J1; Puig, J2; Go´rgolas, M6; Go´mez-Sirvent, J7; Domingo, P8; Rozas, N1; Lo´pez-Bernaldo de Quiro´s, J9; Ocampo, A10 and Vergas, J11
1Hospital Univeristari de Bellvitge, Barcelona, Spain.2Hospital de Can Ruti, Barcelona, Spain.3Hospital Virgen del Rocio, Sevilla, Spain.4Hospital Lozano Blesa,
Zaragoza, Spain.5Hospital del Mar, Barcelona, Spain.6Fundacio´n Jime´nez Dı´az, Madrid, Spain.7Hospital Universitario de Canarias, Tenerife, Spain.8Hospital De San Pau, Barcelona, Spain.9Hospital Gregorio Maran˜o´n, Madrid, Spain.10
Hospital Xeral Cies, Vigo, Spain.11Hospital San Carlos, Madrid, Spain.
Purpose of the study
Very scarce information has been published to date with the combination of ABC/3TC/NVP but it is currently being used in clinical practice in many centers in Spain. Our aim was to present the clinical experience with this regimen in a cohort of adult HIV-infected pts.
Methods
Retrospective, multicenter, cohort study. Consecutive adult HIV-infected ARV-experienced pts, HLA-B*5701-negative, who started ABC/3TC/NVP between 20052010, with at least one follow-up visit, were included. Demographic, clinical and laboratory variables were assessed at baseline, month 1, and every 34 months thereafter. The primary end point was HIV-1 viral load (VL)
B40 c/mL at 48 weeks. Data were analyzed by intent-to-treat (ITT) (non-completerfailure) and on treatment (OT).
Summary of results
227 pts were included and followed up for a median of 30 (0.576) months. 75% male, 47 (2483) years, 21% AIDS, 13% HCV, baseline CD4 570 (321404) cells/mL and VL undetectable in 90% with a median of B1.59 (B1.595.1) log. Most pts were receiving NVP (63%), ABC (25%) or both (4%) in the previous regimen. ABC/3TC/NVP was initiated due to toxicity (42%), simplification (35%) or other reasons (22%) including to reduce drug cost. After 48 weeks, VL wasB40 c/mL in 82% (ITT) and
94% (OT), and in 94% (OT) after 96 weeks. CD4 increased63 (pB0.001) and77 (pB0.001) cells/mL after 48 and 96 weeks,
respectively. One or more drugs of the regimen were discontinued in 18% of pts during follow up: toxicity (7%), virologic failure (3%), lost to follow-up (3%), unrelated death (0.4%) or other reasons (4%). No significant differences were observed in ALT, AST, or triglyceride changes during follow up. A significant increase of 7%, 10% and 14% was observed in total cholesterol, LDLc and HDLc, and a significant decrease in TC/HDL ratio (5%, p0.004) after 96 weeks, respectively.
Conclusions
In this particular cohort of ARV-experienced pts previously receiving NVP or ABC, a combination of ABC/3TC/NVP was safe and mantained virologic suppression in the vast majority of pts, with rates similar to other switch strategies. A favourable lipid profile was observed after 96 weeks of follow up.
Published11 November 2012
Copyright:–2012 Podzamczer D et al; licensee International AIDS Society. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstracts of the Eleventh International Congress on Drug Therapy in HIV Infection Podzamczer D et al.Journal of the International AIDS Society2012,15(Suppl 4):18343
http://www.jiasociety.org/index.php/jias/article/view/18343 | http://dx.doi.org/10.7448/IAS.15.6.18343
