Virologic and immunologic effectiveness of tipranavir/ritonavir (TPV/r)- versus darunavir/ritonavir (DRV/r)-based regimens in clinical practice.
BACKGROUND
Although both tipranavir and darunavir are important options for the management of patients with multidrug resistant HIV, there are at present no studies comparing the effectiveness and safety of these 2 antiretroviral drugs in this population of patients.


OBJECTIVE
To compare the effectiveness and safety of ritonavir (TPV/r)- and darunavir/ritonavir (DRV/ r)-based therapies in treatment-experienced patients (n = 38 and 47, respectively).


METHODS
Multicenter, retrospective cohort study.


RESULTS
The median baseline viral load and CD4 count were 4.7 copies/mL (interquartile range [IQR] 4.3, 5.2) and 168 cells/mm( 3) (IQR 80, 252) for TPV/r patients and 4.7 copies/mL (IQR 3.7, 5.1) and 171 cells/mm(3) (IQR 92, 290) for DRV/r patients. The median number of years on antiretroviral therapy (ART) prior to starting DRV/r or TPV/r were 12.7 (10.2-15.5) and 10.5 (8.4-12.6), respectively (P < .01). Current raltegravir (RAL) use (odds ratio [OR] 5.53, 95% CI 1.08-28.34) was significantly associated with virologic suppression at week 24 in multivariable logistic regression models, whereas the use of TPV/r was not significantly associated with virologic suppression compared to DRV/r (OR 0.93, 95% CI 0.27-3.18, P = .91).


CONCLUSIONS
No significant difference was observed between DRV/r and TPV/r in terms of virologic suppression.
University of Toronto, Toronto, Ontario, Canada, Maple Leaf Medical Clinical, Toronto, Ontario, Canada. tantoniou@smh.toronto.on.ca
Tony
T
Antoniou
J M
JM
Raboud
C
C
Diong
D
D
Su
N
N
Dewhurst
V
V
Buckley
C
C
Kovacs
A
A
Rachlis
J
J
Brunetta
G
G
Smith
K
K
Gough
D
D
Fletcher
M R
MR
Loutfy
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D018791:CD4 Lymphocyte Count; D000069454:Darunavir; D018432:Drug Resistance, Multiple; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology / Q000494:pharmacology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009864:Ontario; D011725:Pyridines / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology / Q000494:pharmacology*; D011753:Pyrones / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology / Q000494:pharmacology*; D012189:Retrospective Studies; D019438:Ritonavir / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology / Q000494:pharmacology*; D013449:Sulfonamides / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology / Q000494:pharmacology*; D016019:Survival Analysis; D019562:Viral Load / Q000187:drug effects
D017320:HIV Protease Inhibitors; D011725:Pyridines; D011753:Pyrones; D013449:Sulfonamides; D019438:Ritonavir; D000069454:Darunavir; C107201:tipranavir