Rate of viral rebound according to specific drugs in the regimen in 2120 patients with HIV suppression

Philips, Andrew N, Ledergerber, Bruno, Horban, Andrzej, Reiss, Peter, Chiesi, Antonio, Kirk, Ole, Mulcahy, Fiona, Fisher, Martin, Machala, Ladislav, Lundgren, Jens D and EuroSIDA Study Group, (2004) Rate of viral rebound according to specific drugs in the regimen in 2120 patients with HIV suppression. AIDS, 18 (13). pp. 1795-1804. ISSN 0269-9370

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Abstract

Background:
It is currently unclear whether the tendency for viral rebound in patients with viral load < 50 copies/ml differs according to the specific drug regimen being used.

Methods:
To follow 2120 patients in EuroSIDA who had attained < 50 copies/ml on highly active antiretroviral therapy (HAART), without previously virologically failing HAART.

Results:
The rate of viral rebound (two consecutive values > 400 copies/ml) was 4.9/100 person-years [95% confidence interval (CI), 4.0–5.8] for patients who were naive pre-HAART and 8.0/100 person-years (95% CI, 7.0–9.0) for those who were experienced with nucleoside analogue reverse transcriptase inhibitors (NRTI) pre-HAART. The rate of rebound was significantly higher in those taking nelfinavir than in those taking efavirenz, both in patients who were naive pre-HAART and those who were NRTI experienced [adjusted rate ratios, 2.83 (95% CI, 1.51–5.31) and 2.86 (95% CI, 1.65–5.00), respectively]. Among patients who were naive pre-HAART, those on abacavir had no evidence of a raised risk of viral rebound (adjusted rate ratio 1.17; 95% CI, 0.51–2.69), but in those with pre-HAART NRTI experience the rate was markedly raised (adjusted rate ratio, 4.48; 95% CI, 2.51–8.00). A similar picture was seen when comparing those on nevirapine with those on efavirenz, although the elevated rate ratio in pre-HAART experienced patients was of lower magnitude (adjusted rate ratio, 1.93). There was no strong evidence that rebound rates differed significantly for any NRTI pairs compared with zidovudine/lamivudine.

Conclusion:
Viral rebound rates in patients who have attained < 50 copies/ml appear to differ according to the specific drugs being used.

Item Type: Article
Schools and Departments: Brighton and Sussex Medical School > Brighton and Sussex Medical School
Depositing User: EPrints Services
Date Deposited: 21 Feb 2012 10:03
Last Modified: 08 Jan 2020 16:27
URI: http://sro.sussex.ac.uk/id/eprint/37933
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