Treatment outcomes amongst previously antiretroviral‐naïve HIV‐infected patients starting lopinavir/ritonavir‐containing antiretroviral regimens at the Royal Free Hospital

• Published in: HIV medicine 2007-01, Vol.8 (1), p.55-63
• Main Authors: Smith, CJ, Phillips, AN, Youle, MS, Sabin, CA, Lampe, FC, Tsintas, R, Tyrer, M, Johnson, MA
• Format: Article
• Language: English
• Subjects: Adult; antiretroviral therapy; CD4 count; CD4 Lymphocyte Count; Drug Therapy, Combination; Female; HIV Infections - drug therapy; HIV Protease Inhibitors - therapeutic use; HIV-1; Human immunodeficiency virus 1; Humans; London; Lopinavir; lopinavir/ritonavir; Male; Pyrimidinones - therapeutic use; Ritonavir - therapeutic use; toxicity; Treatment Outcome; Viral Load
• ISSN: 1464-2662; 1468-1293
• DOI: 10.1111/j.1468-1293.2007.00431.x

Objective To describe outcomes in patients starting first‐line antiretroviral regimens including lopinavir/ritonavir (LPV/r) in a routine clinic setting. Methods Previously naïve patients starting LPV/r‐containing antiretroviral therapy were included in the study. Virological failure was defined as the first of two viral loads >500 HIV‐1 RNA copies/mL more than 6 months after starting LPV/r. Cumulative percentages experiencing virological failure were calculated using Kaplan–Meier methods. Results A total of 195 individuals had a median follow‐up time of 1.7 years. At 48 weeks, 87.9, 77.4 and 71.6% of patients with pretreatment CD4 counts of 200 cells/μL, respectively, remained on LPV/r. By 48, 72 and 96 weeks, 2.2, 3.0 and 5.0% of patients, respectively, had experienced virological failure, ignoring treatment changes but censoring follow‐up at discontinuation of all antiretrovirals; these percentages became 24.0, 33.7 and 42.3% when LPV/r discontinuation was considered as virological failure. Censoring those who stopped LPV/r with a viral load 50 copies/mL gave 12.1, 14.6 and 17.0% virological failure at 48, 72 and 96 weeks, respectively. Median CD4 count increases at 24, 48 and 72 weeks were 167, 230 and 253 cells/μL, respectively. Conclusions Few patients experienced virological failure whilst on a LPV/r‐based regimen, although it was not uncommon for patients in our clinic with higher baseline CD4 counts to discontinue LPV/r.