Abacavir/lamivudine versus tenofovir DF/emtricitabine as part of combination regimens for initial treatment of HIV: final results.

TitleAbacavir/lamivudine versus tenofovir DF/emtricitabine as part of combination regimens for initial treatment of HIV: final results.
Publication TypeJournal Article
Year of Publication2011
AuthorsSax PE, Tierney C, Collier AC, Daar ES, Mollan K, Budhathoki C, Godfrey C, Jahed NC, Myers L, Katzenstein D, Farajallah A, Rooney JF, Ha B, Woodward WC, Feinberg J, Tashima K, Murphy RL, Fischl MA
Corporate AuthorsAIDS Clinical Trials Group Study A5202 Team
JournalJ Infect Dis
Volume204
Issue8
Pagination1191-201
Date Published2011 Oct 15
ISSN1537-6613
KeywordsAdenine, Adult, Anti-HIV Agents, Antiretroviral Therapy, Highly Active, CD4 Lymphocyte Count, Deoxycytidine, Dideoxynucleosides, Double-Blind Method, Emtricitabine, Female, HIV, HIV Infections, Humans, Kaplan-Meier Estimate, Lamivudine, Male, Middle Aged, Organophosphonates, RNA, Viral, Tenofovir, Viral Load
Abstract

BACKGROUND: AIDS Clinical Trials Group A5202 compared blinded abacavir/lamivudine (ABC/3TC) to tenofovir DF/emtricitabine (TDF/FTC) with efavirenz (EFV) or atazanavir/ritonavir (ATV/r) in human immunodeficiency virus (HIV)-infected treatment-naive patients, stratified by screening HIV RNA (< or ≥ 10(5) copies/mL). Due to higher virologic failure with ABC/3TC in the high HIV RNA stratum, blinded treatment was stopped in this group, but study follow-up continued for all patients.

METHODS: Primary endpoints were times to virologic failure, regimen modification, and safety event.

RESULTS: In the low HIV RNA stratum, time to virologic failure was similar for ABC/3TC vs TDF/FTC with ATV/r (hazard ratio [HR] 1.25, 95% confidence interval [CI] 0.76, 2.05) or EFV (HR 1.23, 95% CI 0.77, 1.96), with significantly shorter times to regimen modification for ABC/3TC with EFV or ATV/r and to safety events with EFV. Prior to stopping blinded treatment in the high stratum, higher virologic failure rates were seen with ABC/3TC with EFV (HR 2.46, 95% CI 1.20, 5.05) or ATV/r (HR 2.22, 95% CI 1.19, 4.14).

CONCLUSIONS: In the low HIV RNA stratum, times to virologic failure for ABC/3TC or TDF/FTC were not different with EFV or ATV/r. In the high stratum, virologic failure rate was significantly higher for ABC/3TC than for TDF/FTC when given with either EFV or ATV/r.

DOI10.1093/infdis/jir505
Alternate JournalJ. Infect. Dis.
PubMed ID21917892
PubMed Central IDPMC3173503
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