Response to first-line ritonavir-boosted protease inhibitors (PI/r)-based regimens in HIV positive patients presenting to care with low CD4 counts: Data from the Icona Foundation Cohort

Roberto Cauda; Antonella Cingolani; Andrea De Luca; Iuri Fanti; Gianmaria Baldin; Barbara Rossetti; Antonella D'Arminio Monforte; Alessandro Cozzi-Lepri; Franco Maggiolo; Giuliano Rizzardini; Paolo Emilio Manconi; Nicola Gianotti; Tiziana Quirino; Carmela Pinnetti; Stefano Rusconi; Andrea Antinori; M. Andreoni; G. Angarano; F. Castelli; G. Di Perri; M. Galli; R. Iardino; G. Ippolito; A. Lazzarin; C. F. Perno; F. Von Schloesser; P. Viale; A. Castagna; F. Ceccherini-Silberstein; E. Girardi; S. Lo Caputo; C. Mussini; M. Puoti; P. Bonfanti; S. Bonora; Andrea Gori; G. Lapadula; G. Madeddu; G. Marchetti; L. Monno; E. Quiros Roldan; A. Giacometti; A. Costantini; C. Valeriani; C. Santoro; C. Suardi; V. Donati; G. Verucchi; C. Minardi; C. Abeli; P. Piano; B. Cacopardo; B. Celesia; J. Vecchiet; K. Falasca; L. Sighinolfi; D. Segala; F. Mazzotta; F. Vichi; G. Cassola; C. Viscoli; A. Alessandrini; N. Bobbio; G. Mazzarello; C. Mastroianni; V. Belvisi; I. Caramma; A. Chiodera; A. P. Castelli; A. L. Ridolfo; R. Piolini; S. Salpietro; L. Carenzi; M. C. Moioli; C. Tincati; C. Puzzolante; G. Monza; N. Abrescia; A. Chirianni; G. Borgia; F. Di Martino; L. Maddaloni; I. Gentile; R. Orlando; F. Baldelli; D. Francisci; G. Parruti; T. Ursini; G. Magnani; M. A. Ursitti; V. Vullo; A. Cristaudo; G. Baldin; S. Cicalini; L. Gallo; E. Nicastri; R. Acinapura; M. Capozzi; R. Libertone; S. Savinelli; A. Latini; M. Cecchetto; F. Viviani; M. S. Mura; B. Rossetti; P. Caramello; G. C. Orofino; M. Sciandra; M. Bassetti; A. Londero; G. Pellizzer; V. Manfrin

doi:10.1371/journal.pone.0156360

Response to first-line ritonavir-boosted protease inhibitors (PI/r)-based regimens in HIV positive patients presenting to care with low CD4 counts: Data from the Icona Foundation Cohort

Roberto Cauda, Antonella Cingolani, Andrea De Luca, Iuri Fanti, Gianmaria Baldin, Barbara Rossetti, Antonella D'Arminio Monforte, Alessandro Cozzi-Lepri, Franco Maggiolo, Giuliano Rizzardini, Paolo Emilio Manconi, Nicola Gianotti, Tiziana Quirino, Carmela Pinnetti, Stefano Rusconi, Andrea Antinori, M. Andreoni, G. Angarano, F. Castelli, G. Di PerriM. Galli, R. Iardino, G. Ippolito, A. Lazzarin, C. F. Perno, F. Von Schloesser, P. Viale, A. Castagna, F. Ceccherini-Silberstein, E. Girardi, S. Lo Caputo, C. Mussini, M. Puoti, P. Bonfanti, S. Bonora, Andrea Gori, G. Lapadula, G. Madeddu, G. Marchetti, L. Monno, E. Quiros Roldan, A. Giacometti, A. Costantini, C. Valeriani, C. Santoro, C. Suardi, V. Donati, G. Verucchi, C. Minardi, C. Abeli, P. Piano, B. Cacopardo, B. Celesia, J. Vecchiet, K. Falasca, L. Sighinolfi, D. Segala, F. Mazzotta, F. Vichi, G. Cassola, C. Viscoli, A. Alessandrini, N. Bobbio, G. Mazzarello, C. Mastroianni, V. Belvisi, I. Caramma, A. Chiodera, A. P. Castelli, A. L. Ridolfo, R. Piolini, S. Salpietro, L. Carenzi, M. C. Moioli, C. Tincati, C. Puzzolante, G. Monza, N. Abrescia, A. Chirianni, G. Borgia, F. Di Martino, L. Maddaloni, I. Gentile, R. Orlando, F. Baldelli, D. Francisci, G. Parruti, T. Ursini, G. Magnani, M. A. Ursitti, V. Vullo, A. Cristaudo, G. Baldin, S. Cicalini, L. Gallo, E. Nicastri, R. Acinapura, M. Capozzi, R. Libertone, S. Savinelli, A. Latini, M. Cecchetto, F. Viviani, M. S. Mura, B. Rossetti, P. Caramello, G. C. Orofino, M. Sciandra, M. Bassetti, A. Londero, G. Pellizzer, V. Manfrin

Risultato della ricerca: Contributo in rivista › Articolo in rivista

1 Citazioni (Scopus)

Abstract

Background There are no data comparing the response to PI/r-based regimens in people presenting for care with low CD4 counts or AIDS (LC). Aim To compare the response to LPV/r-, DRV/r- or ATV/r-based cART regimens in LC initiating cART from ART-naive. Methods We included people enrolled in Icona with either CD4 counts ≤350 cells/mm3 (low CD4-LC) or CD4 counts ≤200 cells/mm3 (very low CD4-VLC) and/or AIDS, starting their first PI/rbased regimen after 2008. Initial regimens were compared by intention-to-treat: i) time to viral failure (VF) (first of 2 consecutive VL>200 copies/mL after ≥6 months); II) time to PI/r discontinuation/switching for any cause (TD) and for toxicity (TDT); III) treatment failure (TF) (VF or TD). Kaplan-Meier and Cox analyses were used. Results 1,362 LC patients were included (DRV/r 607; ATV/r 552; LPV/r 203); 813 VLC. In a median of 18 months (IQR:7-35), the 1-year probability of VF and TF were 2.8% (1.9-3.8) and 21.1% (18.7-23.4). In the adjusted analysis, patients initiating ATV/r had a 53% lower chance, and those initiating DRV/r a 61% lower chance of TD, as compared to LPV/r; the risk of TF was more likely in people starting LPV/r. Results were similar among VLC; in this subgroup LPV/r including regimens demonstrated a lower chance of VF. Conclusions We confirmed in LC a low chance of virological failure by 1 year, with small differences according to PI/r. However, larger differences were observed when comparing longer-term endpoints such as treatment failure. These results are important for people presenting late for care.

Lingua originale	English
pagine (da-a)	N/A-N/A
Rivista	PLoS One
Volume	11
DOI	https://doi.org/10.1371/journal.pone.0156360
Stato di pubblicazione	Pubblicato - 2016

Keywords

Agricultural and Biological Sciences (all)
Biochemistry, Genetics and Molecular Biology (all)
Medicine (all)

Accesso al documento

10.1371/journal.pone.0156360

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Cauda, R., Cingolani, A., De Luca, A., Fanti, I., Baldin, G., Rossetti, B., D'Arminio Monforte, A., Cozzi-Lepri, A., Maggiolo, F., Rizzardini, G., Manconi, P. E., Gianotti, N., Quirino, T., Pinnetti, C., Rusconi, S., Antinori, A., Andreoni, M., Angarano, G., Castelli, F., ... Manfrin, V. (2016). Response to first-line ritonavir-boosted protease inhibitors (PI/r)-based regimens in HIV positive patients presenting to care with low CD4 counts: Data from the Icona Foundation Cohort. PLoS One, 11, N/A-N/A. https://doi.org/10.1371/journal.pone.0156360

Cauda, Roberto ; Cingolani, Antonella ; De Luca, Andrea ; Fanti, Iuri ; Baldin, Gianmaria ; Rossetti, Barbara ; D'Arminio Monforte, Antonella ; Cozzi-Lepri, Alessandro ; Maggiolo, Franco ; Rizzardini, Giuliano ; Manconi, Paolo Emilio ; Gianotti, Nicola ; Quirino, Tiziana ; Pinnetti, Carmela ; Rusconi, Stefano ; Antinori, Andrea ; Andreoni, M. ; Angarano, G. ; Castelli, F. ; Di Perri, G. ; Galli, M. ; Iardino, R. ; Ippolito, G. ; Lazzarin, A. ; Perno, C. F. ; Von Schloesser, F. ; Viale, P. ; Castagna, A. ; Ceccherini-Silberstein, F. ; Girardi, E. ; Lo Caputo, S. ; Mussini, C. ; Puoti, M. ; Bonfanti, P. ; Bonora, S. ; Gori, Andrea ; Lapadula, G. ; Madeddu, G. ; Marchetti, G. ; Monno, L. ; Quiros Roldan, E. ; Giacometti, A. ; Costantini, A. ; Valeriani, C. ; Santoro, C. ; Suardi, C. ; Donati, V. ; Verucchi, G. ; Minardi, C. ; Abeli, C. ; Piano, P. ; Cacopardo, B. ; Celesia, B. ; Vecchiet, J. ; Falasca, K. ; Sighinolfi, L. ; Segala, D. ; Mazzotta, F. ; Vichi, F. ; Cassola, G. ; Viscoli, C. ; Alessandrini, A. ; Bobbio, N. ; Mazzarello, G. ; Mastroianni, C. ; Belvisi, V. ; Caramma, I. ; Chiodera, A. ; Castelli, A. P. ; Ridolfo, A. L. ; Piolini, R. ; Salpietro, S. ; Carenzi, L. ; Moioli, M. C. ; Tincati, C. ; Puzzolante, C. ; Monza, G. ; Abrescia, N. ; Chirianni, A. ; Borgia, G. ; Di Martino, F. ; Maddaloni, L. ; Gentile, I. ; Orlando, R. ; Baldelli, F. ; Francisci, D. ; Parruti, G. ; Ursini, T. ; Magnani, G. ; Ursitti, M. A. ; Vullo, V. ; Cristaudo, A. ; Baldin, G. ; Cicalini, S. ; Gallo, L. ; Nicastri, E. ; Acinapura, R. ; Capozzi, M. ; Libertone, R. ; Savinelli, S. ; Latini, A. ; Cecchetto, M. ; Viviani, F. ; Mura, M. S. ; Rossetti, B. ; Caramello, P. ; Orofino, G. C. ; Sciandra, M. ; Bassetti, M. ; Londero, A. ; Pellizzer, G. ; Manfrin, V. / Response to first-line ritonavir-boosted protease inhibitors (PI/r)-based regimens in HIV positive patients presenting to care with low CD4 counts: Data from the Icona Foundation Cohort. In: PLoS One. 2016 ; Vol. 11. pagg. N/A-N/A.

@article{582346ddcef04ea1ab42c04fe73fbbad,

title = "Response to first-line ritonavir-boosted protease inhibitors (PI/r)-based regimens in HIV positive patients presenting to care with low CD4 counts: Data from the Icona Foundation Cohort",

abstract = "Background There are no data comparing the response to PI/r-based regimens in people presenting for care with low CD4 counts or AIDS (LC). Aim To compare the response to LPV/r-, DRV/r- or ATV/r-based cART regimens in LC initiating cART from ART-naive. Methods We included people enrolled in Icona with either CD4 counts ≤350 cells/mm3 (low CD4-LC) or CD4 counts ≤200 cells/mm3 (very low CD4-VLC) and/or AIDS, starting their first PI/rbased regimen after 2008. Initial regimens were compared by intention-to-treat: i) time to viral failure (VF) (first of 2 consecutive VL>200 copies/mL after ≥6 months); II) time to PI/r discontinuation/switching for any cause (TD) and for toxicity (TDT); III) treatment failure (TF) (VF or TD). Kaplan-Meier and Cox analyses were used. Results 1,362 LC patients were included (DRV/r 607; ATV/r 552; LPV/r 203); 813 VLC. In a median of 18 months (IQR:7-35), the 1-year probability of VF and TF were 2.8% (1.9-3.8) and 21.1% (18.7-23.4). In the adjusted analysis, patients initiating ATV/r had a 53% lower chance, and those initiating DRV/r a 61% lower chance of TD, as compared to LPV/r; the risk of TF was more likely in people starting LPV/r. Results were similar among VLC; in this subgroup LPV/r including regimens demonstrated a lower chance of VF. Conclusions We confirmed in LC a low chance of virological failure by 1 year, with small differences according to PI/r. However, larger differences were observed when comparing longer-term endpoints such as treatment failure. These results are important for people presenting late for care.",

keywords = "Agricultural and Biological Sciences (all), Biochemistry, Genetics and Molecular Biology (all), Medicine (all), Agricultural and Biological Sciences (all), Biochemistry, Genetics and Molecular Biology (all), Medicine (all)",

author = "Roberto Cauda and Antonella Cingolani and {De Luca}, Andrea and Iuri Fanti and Gianmaria Baldin and Barbara Rossetti and {D'Arminio Monforte}, Antonella and Alessandro Cozzi-Lepri and Franco Maggiolo and Giuliano Rizzardini and Manconi, {Paolo Emilio} and Nicola Gianotti and Tiziana Quirino and Carmela Pinnetti and Stefano Rusconi and Andrea Antinori and M. Andreoni and G. Angarano and F. Castelli and {Di Perri}, G. and M. Galli and R. Iardino and G. Ippolito and A. Lazzarin and Perno, {C. F.} and {Von Schloesser}, F. and P. Viale and A. Castagna and F. Ceccherini-Silberstein and E. Girardi and {Lo Caputo}, S. and C. Mussini and M. Puoti and P. Bonfanti and S. Bonora and Andrea Gori and G. Lapadula and G. Madeddu and G. Marchetti and L. Monno and {Quiros Roldan}, E. and A. Giacometti and A. Costantini and C. Valeriani and C. Santoro and C. Suardi and V. Donati and G. Verucchi and C. Minardi and C. Abeli and P. Piano and B. Cacopardo and B. Celesia and J. Vecchiet and K. Falasca and L. Sighinolfi and D. Segala and F. Mazzotta and F. Vichi and G. Cassola and C. Viscoli and A. Alessandrini and N. Bobbio and G. Mazzarello and C. Mastroianni and V. Belvisi and I. Caramma and A. Chiodera and Castelli, {A. P.} and Ridolfo, {A. L.} and R. Piolini and S. Salpietro and L. Carenzi and Moioli, {M. C.} and C. Tincati and C. Puzzolante and G. Monza and N. Abrescia and A. Chirianni and G. Borgia and {Di Martino}, F. and L. Maddaloni and I. Gentile and R. Orlando and F. Baldelli and D. Francisci and G. Parruti and T. Ursini and G. Magnani and Ursitti, {M. A.} and V. Vullo and A. Cristaudo and G. Baldin and S. Cicalini and L. Gallo and E. Nicastri and R. Acinapura and M. Capozzi and R. Libertone and S. Savinelli and A. Latini and M. Cecchetto and F. Viviani and Mura, {M. S.} and B. Rossetti and P. Caramello and Orofino, {G. C.} and M. Sciandra and M. Bassetti and A. Londero and G. Pellizzer and V. Manfrin",

year = "2016",

doi = "10.1371/journal.pone.0156360",

language = "English",

volume = "11",

pages = "N/A--N/A",

journal = "PLoS One",

issn = "1932-6203",

publisher = "San Francisco, CA : Public Library of Science",

}

Cauda, R , Cingolani, A, De Luca, A, Fanti, I, Baldin, G, Rossetti, B, D'Arminio Monforte, A, Cozzi-Lepri, A, Maggiolo, F, Rizzardini, G, Manconi, PE, Gianotti, N, Quirino, T, Pinnetti, C, Rusconi, S, Antinori, A, Andreoni, M, Angarano, G, Castelli, F, Di Perri, G, Galli, M, Iardino, R, Ippolito, G, Lazzarin, A, Perno, CF, Von Schloesser, F, Viale, P, Castagna, A, Ceccherini-Silberstein, F, Girardi, E, Lo Caputo, S, Mussini, C, Puoti, M, Bonfanti, P, Bonora, S, Gori, A, Lapadula, G, Madeddu, G, Marchetti, G, Monno, L, Quiros Roldan, E, Giacometti, A, Costantini, A, Valeriani, C, Santoro, C, Suardi, C, Donati, V, Verucchi, G, Minardi, C, Abeli, C, Piano, P, Cacopardo, B, Celesia, B, Vecchiet, J, Falasca, K, Sighinolfi, L, Segala, D, Mazzotta, F, Vichi, F, Cassola, G, Viscoli, C, Alessandrini, A, Bobbio, N, Mazzarello, G, Mastroianni, C, Belvisi, V, Caramma, I, Chiodera, A, Castelli, AP, Ridolfo, AL, Piolini, R, Salpietro, S, Carenzi, L, Moioli, MC, Tincati, C, Puzzolante, C, Monza, G, Abrescia, N, Chirianni, A, Borgia, G, Di Martino, F, Maddaloni, L, Gentile, I, Orlando, R, Baldelli, F, Francisci, D, Parruti, G, Ursini, T, Magnani, G, Ursitti, MA, Vullo, V, Cristaudo, A, Baldin, G, Cicalini, S, Gallo, L, Nicastri, E, Acinapura, R, Capozzi, M, Libertone, R, Savinelli, S, Latini, A, Cecchetto, M, Viviani, F, Mura, MS, Rossetti, B, Caramello, P, Orofino, GC, Sciandra, M, Bassetti, M, Londero, A, Pellizzer, G & Manfrin, V 2016, 'Response to first-line ritonavir-boosted protease inhibitors (PI/r)-based regimens in HIV positive patients presenting to care with low CD4 counts: Data from the Icona Foundation Cohort', PLoS One, vol. 11, pagg. N/A-N/A. https://doi.org/10.1371/journal.pone.0156360

Response to first-line ritonavir-boosted protease inhibitors (PI/r)-based regimens in HIV positive patients presenting to care with low CD4 counts: Data from the Icona Foundation Cohort. / Cauda, Roberto ; Cingolani, Antonella; De Luca, Andrea; Fanti, Iuri; Baldin, Gianmaria; Rossetti, Barbara; D'Arminio Monforte, Antonella; Cozzi-Lepri, Alessandro; Maggiolo, Franco; Rizzardini, Giuliano; Manconi, Paolo Emilio; Gianotti, Nicola; Quirino, Tiziana; Pinnetti, Carmela; Rusconi, Stefano; Antinori, Andrea; Andreoni, M.; Angarano, G.; Castelli, F.; Di Perri, G.; Galli, M.; Iardino, R.; Ippolito, G.; Lazzarin, A.; Perno, C. F.; Von Schloesser, F.; Viale, P.; Castagna, A.; Ceccherini-Silberstein, F.; Girardi, E.; Lo Caputo, S.; Mussini, C.; Puoti, M.; Bonfanti, P.; Bonora, S.; Gori, Andrea; Lapadula, G.; Madeddu, G.; Marchetti, G.; Monno, L.; Quiros Roldan, E.; Giacometti, A.; Costantini, A.; Valeriani, C.; Santoro, C.; Suardi, C.; Donati, V.; Verucchi, G.; Minardi, C.; Abeli, C.; Piano, P.; Cacopardo, B.; Celesia, B.; Vecchiet, J.; Falasca, K.; Sighinolfi, L.; Segala, D.; Mazzotta, F.; Vichi, F.; Cassola, G.; Viscoli, C.; Alessandrini, A.; Bobbio, N.; Mazzarello, G.; Mastroianni, C.; Belvisi, V.; Caramma, I.; Chiodera, A.; Castelli, A. P.; Ridolfo, A. L.; Piolini, R.; Salpietro, S.; Carenzi, L.; Moioli, M. C.; Tincati, C.; Puzzolante, C.; Monza, G.; Abrescia, N.; Chirianni, A.; Borgia, G.; Di Martino, F.; Maddaloni, L.; Gentile, I.; Orlando, R.; Baldelli, F.; Francisci, D.; Parruti, G.; Ursini, T.; Magnani, G.; Ursitti, M. A.; Vullo, V.; Cristaudo, A.; Baldin, G.; Cicalini, S.; Gallo, L.; Nicastri, E.; Acinapura, R.; Capozzi, M.; Libertone, R.; Savinelli, S.; Latini, A.; Cecchetto, M.; Viviani, F.; Mura, M. S.; Rossetti, B.; Caramello, P.; Orofino, G. C.; Sciandra, M.; Bassetti, M.; Londero, A.; Pellizzer, G.; Manfrin, V.

In: PLoS One, Vol. 11, 2016, pag. N/A-N/A.

Risultato della ricerca: Contributo in rivista › Articolo in rivista

TY - JOUR

T1 - Response to first-line ritonavir-boosted protease inhibitors (PI/r)-based regimens in HIV positive patients presenting to care with low CD4 counts: Data from the Icona Foundation Cohort

AU - Cauda, Roberto

AU - Cingolani, Antonella

AU - De Luca, Andrea

AU - Fanti, Iuri

AU - Baldin, Gianmaria

AU - Rossetti, Barbara

AU - D'Arminio Monforte, Antonella

AU - Cozzi-Lepri, Alessandro

AU - Maggiolo, Franco

AU - Rizzardini, Giuliano

AU - Manconi, Paolo Emilio

AU - Gianotti, Nicola

AU - Quirino, Tiziana

AU - Pinnetti, Carmela

AU - Rusconi, Stefano

AU - Antinori, Andrea

AU - Andreoni, M.

AU - Angarano, G.

AU - Castelli, F.

AU - Di Perri, G.

AU - Galli, M.

AU - Iardino, R.

AU - Ippolito, G.

AU - Lazzarin, A.

AU - Perno, C. F.

AU - Von Schloesser, F.

AU - Viale, P.

AU - Castagna, A.

AU - Ceccherini-Silberstein, F.

AU - Girardi, E.

AU - Lo Caputo, S.

AU - Mussini, C.

AU - Puoti, M.

AU - Bonfanti, P.

AU - Bonora, S.

AU - Gori, Andrea

AU - Lapadula, G.

AU - Madeddu, G.

AU - Marchetti, G.

AU - Monno, L.

AU - Quiros Roldan, E.

AU - Giacometti, A.

AU - Costantini, A.

AU - Valeriani, C.

AU - Santoro, C.

AU - Suardi, C.

AU - Donati, V.

AU - Verucchi, G.

AU - Minardi, C.

AU - Abeli, C.

AU - Piano, P.

AU - Cacopardo, B.

AU - Celesia, B.

AU - Vecchiet, J.

AU - Falasca, K.

AU - Sighinolfi, L.

AU - Segala, D.

AU - Mazzotta, F.

AU - Vichi, F.

AU - Cassola, G.

AU - Viscoli, C.

AU - Alessandrini, A.

AU - Bobbio, N.

AU - Mazzarello, G.

AU - Mastroianni, C.

AU - Belvisi, V.

AU - Caramma, I.

AU - Chiodera, A.

AU - Castelli, A. P.

AU - Ridolfo, A. L.

AU - Piolini, R.

AU - Salpietro, S.

AU - Carenzi, L.

AU - Moioli, M. C.

AU - Tincati, C.

AU - Puzzolante, C.

AU - Monza, G.

AU - Abrescia, N.

AU - Chirianni, A.

AU - Borgia, G.

AU - Di Martino, F.

AU - Maddaloni, L.

AU - Gentile, I.

AU - Orlando, R.

AU - Baldelli, F.

AU - Francisci, D.

AU - Parruti, G.

AU - Ursini, T.

AU - Magnani, G.

AU - Ursitti, M. A.

AU - Vullo, V.

AU - Cristaudo, A.

AU - Baldin, G.

AU - Cicalini, S.

AU - Gallo, L.

AU - Nicastri, E.

AU - Acinapura, R.

AU - Capozzi, M.

AU - Libertone, R.

AU - Savinelli, S.

AU - Latini, A.

AU - Cecchetto, M.

AU - Viviani, F.

AU - Mura, M. S.

AU - Rossetti, B.

AU - Caramello, P.

AU - Orofino, G. C.

AU - Sciandra, M.

AU - Bassetti, M.

AU - Londero, A.

AU - Pellizzer, G.

AU - Manfrin, V.

PY - 2016

Y1 - 2016

N2 - Background There are no data comparing the response to PI/r-based regimens in people presenting for care with low CD4 counts or AIDS (LC). Aim To compare the response to LPV/r-, DRV/r- or ATV/r-based cART regimens in LC initiating cART from ART-naive. Methods We included people enrolled in Icona with either CD4 counts ≤350 cells/mm3 (low CD4-LC) or CD4 counts ≤200 cells/mm3 (very low CD4-VLC) and/or AIDS, starting their first PI/rbased regimen after 2008. Initial regimens were compared by intention-to-treat: i) time to viral failure (VF) (first of 2 consecutive VL>200 copies/mL after ≥6 months); II) time to PI/r discontinuation/switching for any cause (TD) and for toxicity (TDT); III) treatment failure (TF) (VF or TD). Kaplan-Meier and Cox analyses were used. Results 1,362 LC patients were included (DRV/r 607; ATV/r 552; LPV/r 203); 813 VLC. In a median of 18 months (IQR:7-35), the 1-year probability of VF and TF were 2.8% (1.9-3.8) and 21.1% (18.7-23.4). In the adjusted analysis, patients initiating ATV/r had a 53% lower chance, and those initiating DRV/r a 61% lower chance of TD, as compared to LPV/r; the risk of TF was more likely in people starting LPV/r. Results were similar among VLC; in this subgroup LPV/r including regimens demonstrated a lower chance of VF. Conclusions We confirmed in LC a low chance of virological failure by 1 year, with small differences according to PI/r. However, larger differences were observed when comparing longer-term endpoints such as treatment failure. These results are important for people presenting late for care.

AB - Background There are no data comparing the response to PI/r-based regimens in people presenting for care with low CD4 counts or AIDS (LC). Aim To compare the response to LPV/r-, DRV/r- or ATV/r-based cART regimens in LC initiating cART from ART-naive. Methods We included people enrolled in Icona with either CD4 counts ≤350 cells/mm3 (low CD4-LC) or CD4 counts ≤200 cells/mm3 (very low CD4-VLC) and/or AIDS, starting their first PI/rbased regimen after 2008. Initial regimens were compared by intention-to-treat: i) time to viral failure (VF) (first of 2 consecutive VL>200 copies/mL after ≥6 months); II) time to PI/r discontinuation/switching for any cause (TD) and for toxicity (TDT); III) treatment failure (TF) (VF or TD). Kaplan-Meier and Cox analyses were used. Results 1,362 LC patients were included (DRV/r 607; ATV/r 552; LPV/r 203); 813 VLC. In a median of 18 months (IQR:7-35), the 1-year probability of VF and TF were 2.8% (1.9-3.8) and 21.1% (18.7-23.4). In the adjusted analysis, patients initiating ATV/r had a 53% lower chance, and those initiating DRV/r a 61% lower chance of TD, as compared to LPV/r; the risk of TF was more likely in people starting LPV/r. Results were similar among VLC; in this subgroup LPV/r including regimens demonstrated a lower chance of VF. Conclusions We confirmed in LC a low chance of virological failure by 1 year, with small differences according to PI/r. However, larger differences were observed when comparing longer-term endpoints such as treatment failure. These results are important for people presenting late for care.

KW - Agricultural and Biological Sciences (all)

KW - Biochemistry, Genetics and Molecular Biology (all)

KW - Medicine (all)

KW - Agricultural and Biological Sciences (all)

KW - Biochemistry, Genetics and Molecular Biology (all)

KW - Medicine (all)

UR - http://hdl.handle.net/10807/94873

UR - http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0156360

U2 - 10.1371/journal.pone.0156360

DO - 10.1371/journal.pone.0156360

M3 - Article

VL - 11

SP - N/A-N/A

JO - PLoS One

JF - PLoS One

SN - 1932-6203

ER -