PI Efficacy at Higher and Lower Baseline HIV-1 RNA
{"Image DocumentName": "PI Efficacy at Higher and Lower Baseline HIV-1 RNA", "Image ImageDescription": "Systematic review of 21 treatment arms from 12 treatment-naive clinical trials reported from January March 2008 (N = 4895) Conclusion: significantly \u2191 rates of HIV-1 RNA < 50 copies/mL at 48 wks with TDF/FTC vs ABC/3TC by ITT-TLOVR or nearest equivalent endpoint. LPV/RTV. TDF (n = 1798) < 100,000 copies/mL. ABC (n = 787) \u2265 100,000 copies/mL. ATV/RTV. TDF (n = 440) ABC (n = 433) FPV/RTV. 3TC, lamivudine; ABC, abacavir; ATV, atazanavir; DRV, darunavir; FPV, fosamprenavir; FTC, emtricitabine; ITT-TLOVR, intent-to-treat-time to loss of virologic response; LPV, lopinavir; RTV, ritonavir; TDF, tenofovir; VF, virologic failure. On the other hand, the data are not quite the same with boosted PIs. These data are from a presentation by Hill and colleagues at the 2008 joint Interscience Conference on Antimicrobial Agents and Chemotherapy/Infectious Diseases Society of America meeting. In this graph, individuals who had HIV-1 RNA < 100,000 copies/mL at baseline are represented by dark circles and patients who had HIV-1 RNA \u2265 100,000 copies/mL at baseline are represented by open circles. These are 48\u2011week data. For each boosted PI pair, regardless of whether patients received tenofovir or abacavir, a higher response rate was seen when HIV-1 RNA was < 100,000 copies/mL than when baseline HIV-1 RNA was \u2265 100,000 copies/mL. The clinical importance of this finding is not entirely clear, and although these are data from randomized studies, these are not randomized comparisons. However, it is helpful to keep in mind that at very high HIV-1 RNA levels, the pace of suppression to HIV-1 RNA < 50 copies/mL seems to be at a lower rate with the boosted PIs. TDF (n = 53) ABC (n = 756) DRV/RTV. TDF (n = 343) HIV-1 RNA < 50 copies/mL at 48 Wks (%) Hill A, et al. ICAAC/IDSA Abstract", "Image XResolution": "37", "Image YResolution": "37", "Image ResolutionUnit": "Pixels/Centimeter", "Image Software": "SlidePlayer", "Image YCbCrPositioning": "Centered"}