Switch to Ritonavir-Boosted versus Unboosted Atazanavir plus Raltegravir Dual-Drug Therapy Leads to Similar Efficacy and Safety Outcomes in Clinical Practice

• Published in: PloS one 2016-10, Vol.11 (10), p.e0164240-e0164240
• Main Authors: Gantner, Pierre, Bani-Sadr, Firouze, Garraffo, Rodolphe, Roger, Pierre-Marie, Treger, Michèle, Jovelin, Thomas, Pugliese, Pascal, Rey, David
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adults; Aged; AIDS; Anti-HIV Agents - pharmacology; Anti-HIV Agents - therapeutic use; Antiretroviral agents; Antiretroviral drugs; Antiretroviral therapy; Antiretroviral Therapy, Highly Active; Antiviral drugs; Atazanavir Sulfate - pharmacology; Atazanavir Sulfate - therapeutic use; Biology and Life Sciences; CD4 antigen; CD4 Lymphocyte Count; Coinfection; Drug Resistance, Viral; Drug Substitution; Drug therapy; Failure; Failure analysis; Female; Genotype; Health aspects; Highly active antiretroviral therapy; HIV; HIV Infections - drug therapy; HIV Infections - immunology; HIV Infections - virology; HIV-1 - drug effects; HIV-1 - genetics; Human immunodeficiency virus; Humans; Infections; Laboratories; Lentivirus; Lipids; Lymphocytes T; Male; Medical research; Medicine and Health Sciences; Middle Aged; Multivariate analysis; Patients; Pharmacology; Physical Sciences; Plasma levels; Rankings; Research and Analysis Methods; Retreatment; Retrospective Studies; Retroviridae; Ribonucleic acid; Ritonavir; Ritonavir - pharmacology; Ritonavir - therapeutic use; RNA; Safety; Studies; Success; T cells; Therapy; Time-to-Treatment; Treatment Outcome; Viral Load
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0164240

To assess immunovirological response, safety and pharmacokinetic of NRTI-sparing regimen dual therapy of atazanavir (ATV) and raltegravir (RAL) in maintenance strategy. A retrospective analysis was conducted on a cohort of HIV-infected adults followed in French centers (Dat'AIDS cohort), comparing the proportions of virological and therapeutic failures between ATV + RAL and ATV/ritonavir + RAL dual therapy regimens. 283 patients were assessed: 185 switched for ATV + RAL and 98 for ATV/ritonavir + RAL dual therapy. Virological failure rate at week 96 was 13.8% (95% CI, 9.8-17.8), without difference between the two groups (Log-rank Test, p = 0.87). The cumulative percentages of patients remaining free of therapeutic failure at week 24, 48 and 96 of dual therapy were 74.9% (95% CI, 69.9-80.0), 65.4% (95% CI, 59.8-70.9) and 53.4% (95% CI, 47.5-59.2), respectively. Four out of 39 confirmed virological failures developed RAL resistance. By multivariate analysis, virological failure was associated with high HIV-1 RNA zenith (p = 0.02), low CD4+ T-cell count at baseline (p