Virological responses to lamivudine or emtricitabine when combined with tenofovir and a protease inhibitor in treatment-naïve HIV-1-infected patients in the Dutch AIDS Therapy Evaluation in the Netherlands (ATHENA) cohort

C. Rokx, L. Gras, D. A.M.C. van de Vijver, A. Verbon, B. J.A. Rijnders, ATHENA cohort

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objectives: Lamivudine (3TC) and emtricitabine (FTC) are considered interchangeable in recommended tenofovir disoproxil-fumarate (TDF)-containing combination antiretroviral therapies (cARTs). This statement of equivalence has not been systematically studied. We compared the treatment responses to 3TC and FTC combined with TDF in boosted protease inhibitor (PI)-based cART for HIV-1-infected patients. Methods: An observational study in the AIDS Therapy Evaluation in the Netherlands (ATHENA) cohort was carried out between 2002 and 2013. Virological failure rates, time to HIV RNA suppression < 400 copies/mL, and time to treatment failure were analysed using multivariable logistic regression and Cox proportional hazard models. Sensitivity analyses included propensity score-adjusted models. Results: A total of 1582 ART-naïve HIV-1-infected patients initiated 3TC or FTC with TDF and ritonavir-boosted darunavir (29.6%), atazanavir (41.5%), lopinavir (27.1%) or another PI (1.8%). Week 48 virological failure rates on 3TC and FTC were comparable (8.9% and 5.6%, respectively; P = 0.208). The multivariable adjusted odds ratio of virological failure when using 3TC instead of FTC with TDF in PI-based cART was 0.75 [95% confidence interval (CI) 0.32–1.79; P = 0.51]. Propensity score-adjusted models showed comparable results. The adjusted hazard ratio (HR) for treatment failure of 3TC compared with FTC was 1.15 (95% CI 0.58–2.27) within 240 weeks after cART initiation. The time to two consecutive HIV RNA measurements < 400 copies/mL within 48 weeks (HR 0.94; 95% CI 0.78–1.16) and the time to treatment failure after suppression < 400 copies/mL (HR 0.94; 95% CI 0.36–2.50) were not significantly influenced by the use of 3TC in TDF/PI-containing cART. Conclusions: The virological responses were not significantly different in treatment-naïve HIV-1-infected patients starting either 3TC/TDF or FTC/TDF and a ritonavir-boosted PI.

Original languageEnglish
Pages (from-to)571-580
Number of pages10
JournalHIV Medicine
Volume17
Issue number8
DOIs
Publication statusPublished - 1 Sep 2016

Cite this

@article{591ae248459b48ba83220fbc19ec158c,
title = "Virological responses to lamivudine or emtricitabine when combined with tenofovir and a protease inhibitor in treatment-na{\"i}ve HIV-1-infected patients in the Dutch AIDS Therapy Evaluation in the Netherlands (ATHENA) cohort",
abstract = "Objectives: Lamivudine (3TC) and emtricitabine (FTC) are considered interchangeable in recommended tenofovir disoproxil-fumarate (TDF)-containing combination antiretroviral therapies (cARTs). This statement of equivalence has not been systematically studied. We compared the treatment responses to 3TC and FTC combined with TDF in boosted protease inhibitor (PI)-based cART for HIV-1-infected patients. Methods: An observational study in the AIDS Therapy Evaluation in the Netherlands (ATHENA) cohort was carried out between 2002 and 2013. Virological failure rates, time to HIV RNA suppression < 400 copies/mL, and time to treatment failure were analysed using multivariable logistic regression and Cox proportional hazard models. Sensitivity analyses included propensity score-adjusted models. Results: A total of 1582 ART-na{\"i}ve HIV-1-infected patients initiated 3TC or FTC with TDF and ritonavir-boosted darunavir (29.6{\%}), atazanavir (41.5{\%}), lopinavir (27.1{\%}) or another PI (1.8{\%}). Week 48 virological failure rates on 3TC and FTC were comparable (8.9{\%} and 5.6{\%}, respectively; P = 0.208). The multivariable adjusted odds ratio of virological failure when using 3TC instead of FTC with TDF in PI-based cART was 0.75 [95{\%} confidence interval (CI) 0.32–1.79; P = 0.51]. Propensity score-adjusted models showed comparable results. The adjusted hazard ratio (HR) for treatment failure of 3TC compared with FTC was 1.15 (95{\%} CI 0.58–2.27) within 240 weeks after cART initiation. The time to two consecutive HIV RNA measurements < 400 copies/mL within 48 weeks (HR 0.94; 95{\%} CI 0.78–1.16) and the time to treatment failure after suppression < 400 copies/mL (HR 0.94; 95{\%} CI 0.36–2.50) were not significantly influenced by the use of 3TC in TDF/PI-containing cART. Conclusions: The virological responses were not significantly different in treatment-na{\"i}ve HIV-1-infected patients starting either 3TC/TDF or FTC/TDF and a ritonavir-boosted PI.",
keywords = "antiretroviral therapy, boosted protease inhibitors, emtricitabine, HIV-1, lamivudine",
author = "C. Rokx and L. Gras and {van de Vijver}, {D. A.M.C.} and A. Verbon and Rijnders, {B. J.A.} and Prins, {J. M.} and Kuijpers, {T. W.} and Scherpbier, {H. J.} and {van der Meer}, {J. T.M.} and Wit, {F. W.M.N.} and Godfried, {M. H.} and P. Reiss and {van der Poll}, T. and Nellen, {F. J.B.} and Lange, {J. M.A.} and Geerlings, {S. E.} and {van Vugt}, M. and D. Pajkrt and Bos, {J. C.} and {van der Valk}, M. and Wiersinga, {W. J.} and A. Goorhuis and Hovius, {J. W.R.} and S. Lowe and {Oude Lashof}, A. and D. Posthouwer and Pronk, {M. J.H.} and Ammerlaan, {H. S.M.} and {van der Ende}, {M. E.} and {de Vries-Sluijs}, {T. E.M.S.} and Schurink, {C. A.M.} and Nouwen, {J. L.} and A. Verbon and Rijnders, {B. J.A.} and {van Gorp}, {E. C.M.} and {van der Feltz}, M. and Driessen, {G. J.A.} and {van Rossum}, {A. M.C.} and J. Branger and Schippers, {E. F.} and {van Nieuwkoop}, C. and {van Elzakker}, {E. P.} and Groeneveld, {P. H.P.} and Bouwhuis, {J. W.} and R. Soetekouw and {van Agtmael}, {M. A.} and Perenboom, {R. M.} and Claessen, {F. A.P.} and M. Bomers and Peters, {E. J.G.} and {ATHENA cohort}",
year = "2016",
month = "9",
day = "1",
doi = "10.1111/hiv.12355",
language = "English",
volume = "17",
pages = "571--580",
journal = "HIV Medicine",
issn = "1464-2662",
number = "8",

}

Virological responses to lamivudine or emtricitabine when combined with tenofovir and a protease inhibitor in treatment-naïve HIV-1-infected patients in the Dutch AIDS Therapy Evaluation in the Netherlands (ATHENA) cohort. / Rokx, C.; Gras, L.; van de Vijver, D. A.M.C.; Verbon, A.; Rijnders, B. J.A.; ATHENA cohort.

In: HIV Medicine, Vol. 17, No. 8, 01.09.2016, p. 571-580.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Virological responses to lamivudine or emtricitabine when combined with tenofovir and a protease inhibitor in treatment-naïve HIV-1-infected patients in the Dutch AIDS Therapy Evaluation in the Netherlands (ATHENA) cohort

AU - Rokx, C.

AU - Gras, L.

AU - van de Vijver, D. A.M.C.

AU - Verbon, A.

AU - Rijnders, B. J.A.

AU - Prins, J. M.

AU - Kuijpers, T. W.

AU - Scherpbier, H. J.

AU - van der Meer, J. T.M.

AU - Wit, F. W.M.N.

AU - Godfried, M. H.

AU - Reiss, P.

AU - van der Poll, T.

AU - Nellen, F. J.B.

AU - Lange, J. M.A.

AU - Geerlings, S. E.

AU - van Vugt, M.

AU - Pajkrt, D.

AU - Bos, J. C.

AU - van der Valk, M.

AU - Wiersinga, W. J.

AU - Goorhuis, A.

AU - Hovius, J. W.R.

AU - Lowe, S.

AU - Oude Lashof, A.

AU - Posthouwer, D.

AU - Pronk, M. J.H.

AU - Ammerlaan, H. S.M.

AU - van der Ende, M. E.

AU - de Vries-Sluijs, T. E.M.S.

AU - Schurink, C. A.M.

AU - Nouwen, J. L.

AU - Verbon, A.

AU - Rijnders, B. J.A.

AU - van Gorp, E. C.M.

AU - van der Feltz, M.

AU - Driessen, G. J.A.

AU - van Rossum, A. M.C.

AU - Branger, J.

AU - Schippers, E. F.

AU - van Nieuwkoop, C.

AU - van Elzakker, E. P.

AU - Groeneveld, P. H.P.

AU - Bouwhuis, J. W.

AU - Soetekouw, R.

AU - van Agtmael, M. A.

AU - Perenboom, R. M.

AU - Claessen, F. A.P.

AU - Bomers, M.

AU - Peters, E. J.G.

AU - ATHENA cohort

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Objectives: Lamivudine (3TC) and emtricitabine (FTC) are considered interchangeable in recommended tenofovir disoproxil-fumarate (TDF)-containing combination antiretroviral therapies (cARTs). This statement of equivalence has not been systematically studied. We compared the treatment responses to 3TC and FTC combined with TDF in boosted protease inhibitor (PI)-based cART for HIV-1-infected patients. Methods: An observational study in the AIDS Therapy Evaluation in the Netherlands (ATHENA) cohort was carried out between 2002 and 2013. Virological failure rates, time to HIV RNA suppression < 400 copies/mL, and time to treatment failure were analysed using multivariable logistic regression and Cox proportional hazard models. Sensitivity analyses included propensity score-adjusted models. Results: A total of 1582 ART-naïve HIV-1-infected patients initiated 3TC or FTC with TDF and ritonavir-boosted darunavir (29.6%), atazanavir (41.5%), lopinavir (27.1%) or another PI (1.8%). Week 48 virological failure rates on 3TC and FTC were comparable (8.9% and 5.6%, respectively; P = 0.208). The multivariable adjusted odds ratio of virological failure when using 3TC instead of FTC with TDF in PI-based cART was 0.75 [95% confidence interval (CI) 0.32–1.79; P = 0.51]. Propensity score-adjusted models showed comparable results. The adjusted hazard ratio (HR) for treatment failure of 3TC compared with FTC was 1.15 (95% CI 0.58–2.27) within 240 weeks after cART initiation. The time to two consecutive HIV RNA measurements < 400 copies/mL within 48 weeks (HR 0.94; 95% CI 0.78–1.16) and the time to treatment failure after suppression < 400 copies/mL (HR 0.94; 95% CI 0.36–2.50) were not significantly influenced by the use of 3TC in TDF/PI-containing cART. Conclusions: The virological responses were not significantly different in treatment-naïve HIV-1-infected patients starting either 3TC/TDF or FTC/TDF and a ritonavir-boosted PI.

AB - Objectives: Lamivudine (3TC) and emtricitabine (FTC) are considered interchangeable in recommended tenofovir disoproxil-fumarate (TDF)-containing combination antiretroviral therapies (cARTs). This statement of equivalence has not been systematically studied. We compared the treatment responses to 3TC and FTC combined with TDF in boosted protease inhibitor (PI)-based cART for HIV-1-infected patients. Methods: An observational study in the AIDS Therapy Evaluation in the Netherlands (ATHENA) cohort was carried out between 2002 and 2013. Virological failure rates, time to HIV RNA suppression < 400 copies/mL, and time to treatment failure were analysed using multivariable logistic regression and Cox proportional hazard models. Sensitivity analyses included propensity score-adjusted models. Results: A total of 1582 ART-naïve HIV-1-infected patients initiated 3TC or FTC with TDF and ritonavir-boosted darunavir (29.6%), atazanavir (41.5%), lopinavir (27.1%) or another PI (1.8%). Week 48 virological failure rates on 3TC and FTC were comparable (8.9% and 5.6%, respectively; P = 0.208). The multivariable adjusted odds ratio of virological failure when using 3TC instead of FTC with TDF in PI-based cART was 0.75 [95% confidence interval (CI) 0.32–1.79; P = 0.51]. Propensity score-adjusted models showed comparable results. The adjusted hazard ratio (HR) for treatment failure of 3TC compared with FTC was 1.15 (95% CI 0.58–2.27) within 240 weeks after cART initiation. The time to two consecutive HIV RNA measurements < 400 copies/mL within 48 weeks (HR 0.94; 95% CI 0.78–1.16) and the time to treatment failure after suppression < 400 copies/mL (HR 0.94; 95% CI 0.36–2.50) were not significantly influenced by the use of 3TC in TDF/PI-containing cART. Conclusions: The virological responses were not significantly different in treatment-naïve HIV-1-infected patients starting either 3TC/TDF or FTC/TDF and a ritonavir-boosted PI.

KW - antiretroviral therapy

KW - boosted protease inhibitors

KW - emtricitabine

KW - HIV-1

KW - lamivudine

UR - http://www.scopus.com/inward/record.url?scp=84983494522&partnerID=8YFLogxK

U2 - 10.1111/hiv.12355

DO - 10.1111/hiv.12355

M3 - Article

VL - 17

SP - 571

EP - 580

JO - HIV Medicine

JF - HIV Medicine

SN - 1464-2662

IS - 8

ER -