title: A randomized trial of simplified maintenance therapy with abacavir, lamivudine, and zidovudine in human immunodeficiency virus infection.
abstract: 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.
authors: Division of Infectious Diseases, University Hospital, CH-8091 Zurich, Switzerland. Milos.Opravil@dim.usz.ch
authors: Milos
authors: M
authors: Opravil
authors: Bernard
authors: B
authors: Hirschel
authors: Adriano
authors: A
authors: Lazzarin
authors: Hansjakob
authors: H
authors: Furrer
authors: Jean-Philippe
authors: JP
authors: Chave
authors: Sabine
authors: S
authors: Yerly
authors: Leslie R
authors: LR
authors: Bisset
authors: Marek
authors: M
authors: Fischer
authors: Pietro
authors: P
authors: Vernazza
authors: Enos
authors: E
authors: Bernasconi
authors: Manuel
authors: M
authors: Battegay
authors: Bruno
authors: B
authors: Ledergerber
authors: Huldrych
authors: H
authors: Günthard
authors: Colin
authors: C
authors: Howe
authors: Rainer
authors: R
authors: Weber
authors: Luc
authors: L
authors: Perrin
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000378:metabolism / Q000821:virology; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D015224:Dideoxynucleosides / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D015497:HIV-1; D006801:Humans; D019259:Lamivudine / Q000008:administration & dosage*; D008055:Lipids / Q000097:blood; D008297:Male; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D017211:Treatment Failure; D019562:Viral Load; D015215:Zidovudine / Q000008:administration & dosage*; D000099227:Abacavir
chemical_list: D019380:Anti-HIV Agents; D015224:Dideoxynucleosides; D019259:Lamivudine; D008055:Lipids; D012367:RNA, Viral; D015215:Zidovudine; D000099227:Abacavir