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Differences in durability of treatment with initial PI-based regimens.
Maria Jesús Pérez-Elías1, Ana Moreno, Santiago Moreno
1Infectious Diseases Unit, Hospital Ramón y Cajal, Madrid, Spain. mjperez@telefonica.net
HIV Clinical Trials
|November 25, 2003
Summary
Nelfinavir-based highly active antiretroviral therapy (HAART) showed similar initial effectiveness to indinavir-based HAART but offered greater durability. Better adherence and tolerability likely contributed to nelfinavir
Area of Science:
- Infectious Diseases
- Virology
- Clinical Pharmacology
Background:
- Antiretroviral therapy durability is key for managing HIV-1.
- Highly active antiretroviral therapy (HAART) regimens vary in potency, tolerability, and adherence impact.
Purpose of the Study:
- To compare the 1-year treatment outcomes of nelfinavir-based versus indinavir-based HAART in treatment-naïve HIV-1 patients.
- To identify factors predicting long-term virologic suppression.
Main Methods:
- Prospective, nonrandomized cohort study of 134 treatment-naïve HIV-1 patients.
- Comparison of nelfinavir (n=44) vs. indinavir (n=90) triple therapy regimens.
- Assessment of virologic response, adherence, and treatment durability over 1 year.
Main Results:
- Similar virologic response rates at 3 months and 1 year between nelfinavir and indinavir groups.
- Higher adherence (>90%) observed in the nelfinavir group (70%) compared to the indinavir group (41%).
- Nelfinavir group showed greater treatment durability (77% remaining on initial PI) vs. indinavir group (66%), with fewer treatment changes due to intolerance.
Conclusions:
- Both nelfinavir and indinavir-based HAART achieve comparable virologic and immunologic suppression at 1 year.
- Nelfinavir-based therapy demonstrates superior durability, likely due to better patient adherence and tolerability.
- Adherence and initial virologic response are critical predictors of long-term virologic suppression in HIV-1 treatment.