Predictors of loss of virologic response in subjects who simplified to lopinavir/ritonavir monotherapy from lopinavir/ritonavir plus zidovudine/lamivudine

Rafael E Campo, Barbara A. Da Silva, Laurent Cotte, Joseph C. Gathe, Brian Gazzard, Charles B. Hicks, Cheri E. Klein, Yi Lin Chiu, Martin S. King, Barry M. Bernstein

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Previous studies have demonstrated that lopinavir/ritonavir monotherapy maintained plasma HIV-1 RNA suppression in a large proportion of antiretroviral naive subjects. However, more subjects receiving lopinavir/ ritonavir monotherapy experienced confirmed virologie rebound >50 copies/ml compared to a standard three-drug HAART regimen. In this study, we sought to determine the factors associated with maintenance of virologie suppression in subjects receiving lopinavir/ritonavir monotherapy. Antiretroviral-naive HIV-1-infected volunteers were randomized 2:1 to initiate a lopinavir/ritonavir-based combination regimen followed by simplification to lopinavir/ritonavir monotherapy or an efavirenz-based triple combination therapy and followed for 96 weeks. Potential predictors of time to loss of virologic response included baseline demographics, baseline HIV-1 RNA levels, baseline CD4 + T cell counts, adherence as determined by 4-day subject recall, duration of HIV-1 RNA <50 copies/ml prior to simplification, and lopinavir concentrations. By the Cox proportional hazards model, higher reported adherence levels and higher baseline CD4 + T cell counts were associated with a greater likelihood of maintaining virologie suppression while receiving lopinavir/ritonavir monotherapy. Lopinavir concentrations, including trough concentrations, were not significantly associated with virologic outcomes. This analysis suggests that adherence and higher baseline CD4 + T cell counts may help to predict who will sustain virologic suppression with lopinavir/ritonavir monotherapy. The data also suggest that measuring lopinavir concentrations is not useful in predicting virologic response in these patients.

Original languageEnglish
Pages (from-to)269-275
Number of pages7
JournalAIDS Research and Human Retroviruses
Volume25
Issue number3
DOIs
StatePublished - Mar 1 2009

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Lopinavir
Ritonavir
Lamivudine
Zidovudine
HIV-1
CD4 Lymphocyte Count
efavirenz
RNA
T-Lymphocytes
Highly Active Antiretroviral Therapy
Proportional Hazards Models
Volunteers
Maintenance
Demography

ASJC Scopus subject areas

  • Immunology
  • Virology
  • Infectious Diseases

Cite this

Predictors of loss of virologic response in subjects who simplified to lopinavir/ritonavir monotherapy from lopinavir/ritonavir plus zidovudine/lamivudine. / Campo, Rafael E; Da Silva, Barbara A.; Cotte, Laurent; Gathe, Joseph C.; Gazzard, Brian; Hicks, Charles B.; Klein, Cheri E.; Chiu, Yi Lin; King, Martin S.; Bernstein, Barry M.

In: AIDS Research and Human Retroviruses, Vol. 25, No. 3, 01.03.2009, p. 269-275.

Research output: Contribution to journalArticle

Campo, RE, Da Silva, BA, Cotte, L, Gathe, JC, Gazzard, B, Hicks, CB, Klein, CE, Chiu, YL, King, MS & Bernstein, BM 2009, 'Predictors of loss of virologic response in subjects who simplified to lopinavir/ritonavir monotherapy from lopinavir/ritonavir plus zidovudine/lamivudine', AIDS Research and Human Retroviruses, vol. 25, no. 3, pp. 269-275. https://doi.org/10.1089/aid.2008.0217
Campo, Rafael E ; Da Silva, Barbara A. ; Cotte, Laurent ; Gathe, Joseph C. ; Gazzard, Brian ; Hicks, Charles B. ; Klein, Cheri E. ; Chiu, Yi Lin ; King, Martin S. ; Bernstein, Barry M. / Predictors of loss of virologic response in subjects who simplified to lopinavir/ritonavir monotherapy from lopinavir/ritonavir plus zidovudine/lamivudine. In: AIDS Research and Human Retroviruses. 2009 ; Vol. 25, No. 3. pp. 269-275.
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