title: Comparison of the Effectiveness of Low-Dose Indinavir/Ritonavir (IDV/r)- versus Atazanavir/Ritonavir (ATV/r)-Based Generic Antiretroviral Therapy in NNRTI-Experienced HIV-1-Infected Patients in India.
abstract: BACKGROUND
  Currently, data on the effectiveness of second-line antiretroviral regimens using indinavir/ritonavir (IDV/r) and atazanavir/ritonavir (ATV/r) along with 2 nucleoside reverse transcriptase inhibitor (NRTI) in resource-poor settings is limited.
  
  
  METHODS
  Observational follow-up study on 441 patients who experienced treatment failure to first-line nonnucleoside reverse transcriptase inhibitor (NNRTI)-based treatment. Multivariate Cox Proportional Hazards Model was used to assess comparative effectiveness of treatment regimens.
  
  
  RESULTS
  A total of 63 patients (14.8%) had failed second line treatments, of which 53 patients (17.2%) were using IDV/r while 10 patients (8.5%) were on ATV/r. After adjusting for age, weight, gender, and baseline CD4 count, patients who took IDV/r were more than twice as likely to experience treatment failure as compared to those who were on ATV/r (hazard ratio [HR] 2.18; 95% confidence interval [CI] 1.14, 4.15). Successful response to second-line therapy was not different between the 2 treatment groups when patients weighed less than 55 kg at baseline (log rank P value = 1.00) in contrast to the individuals weighing ≥55 kg (P < .0001).
  
  
  CONCLUSIONS
  We found that successful response to second-line therapy was twice as likely in the ATV/r group; however, this difference was eliminated in patients less than 55 kg.
authors.affiliation: Infectious Diseases Clinic, "VEDANTA" Institute of Medical Sciences, Navarangpura, Ahmedabad, India, atulpatel65@gmail.com.
authors.forename: Atul K
authors.initials: AK
authors.lastname: Patel
authors.forename: Ketan K
authors.initials: KK
authors.lastname: Patel
authors.forename: Eknath
authors.initials: E
authors.lastname: Naik
authors.lastname: Jingyi Duan
authors.forename: Rajiv
authors.initials: R
authors.lastname: Ranjan
authors.forename: Jagdish K
authors.initials: JK
authors.lastname: Patel
authors.forename: Hamisu M
authors.initials: HM
authors.lastname: Salihu
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use; D000069446:Atazanavir Sulfate; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy; D015497:HIV-1; D006801:Humans; D019469:Indinavir; D019438:Ritonavir / Q000008:administration & dosage; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D000069446:Atazanavir Sulfate; D019469:Indinavir; D019438:Ritonavir