Publication
A randomized trial of simplified maintenance therapy with abacavir, lamivudine, and zidovudine in human immunodeficiency virus infection
Journal Paper/Review - May 1, 2002
Opravil Milos, Perrin Luc, Weber Rainer, Howe Colin, Günthard Huldrych, Ledergerber Bruno, Battegay Manuel, Bernasconi Enos, Vernazza Pietro, Fischer Marek, Bisset Leslie R, Yerly Sabine, Chave Jean-Philippe, Furrer Hansjakob, Lazzarin Adriano, Hirschel Bernard, Swiss HIV Cohort Study
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Brief description/objective
This randomized study evaluated the efficacy and tolerability of continued treatment with protease inhibitor plus nucleoside-analogue combination regimens (n=79) or a change to the simplified regimen of abacavir-lamivudine-zidovudine (n=84) in patients with suppressed human immunodeficiency virus type 1 (HIV-1) RNA for > or = 6 months who did not have the reverse transcriptase 215 mutation. After a median follow-up of 84 weeks, virologic failure was 6% in the continuation and 15% in the simplified group (P=.081). Previous zidovudine monotherapy or dual therapy and archived reverse transcriptase resistance mutations in HIV-1 DNA at baseline were significant predictors of failure. Study treatment was discontinued because of adverse events in 20% of the continuation and 7% of the simplified group (P=.021). Simplification to abacavir-lamivudine-zidovudine significantly decreased nonfasting cholesterol and triglyceride levels; however, this switch strategy carries a risk of virologic failure when treatment history or resistance testing suggest the presence of archived resistance mutations to the simplified regimen.