title: Efavirenz outperforms boosted atazanavir among treatment-naive HIV-1-infected persons in routine clinical care.
abstract: BACKGROUND
  Effectiveness of antiretroviral therapy (ART) in a routine clinical care may result different from the clinical trials. We assessed the virologic outcomes in treatment-naive persons who received either efavirenz (EFV) or atazanavir/ritonavir (ATV/r) with a backbone of tenofovir/emtricitabine (TDF/FTC) as their combination ART (cART).
  
  
  METHODS
  This was a retrospective cohort study conducted at the Washington University HIV Outpatient Clinic from January 2004 to June 2009. Predictors of virologic suppression (HIV RNA level <400 copies/mL) by week 48 were assessed by multivariate Cox proportional hazards regression models.
  
  
  RESULTS
  Of 324 persons, 221(68%) received EFV and 103 (32%) received ATV/r. Persons on EFV had 1.4-fold increased likelihood of virologic suppression (95% confidence interval, 1.0-1.8) when compared to ATV/r after adjustment with primary drug resistance, pre-cART opportunistic infection, HIV RNA levels, and timing to start cART.
  
  
  CONCLUSIONS
  In routine clinical care settings, EFV had higher likelihood of achieving virologic suppression than ATV/r with backbone of TDF/FTC.
authors.affiliation: Division of Infectious Diseases, Washington University School of Medicine, St Louis, MO 63110, USA. tosh-tanig@umin.org
authors.forename: Toshibumi
authors.initials: T
authors.lastname: Taniguchi
authors.forename: Jessica R
authors.initials: JR
authors.lastname: Grubb
authors.forename: Diana
authors.initials: D
authors.lastname: Nurutdinova
authors.forename: Nur F
authors.initials: NF
authors.lastname: Önen
authors.forename: Enbal
authors.initials: E
authors.lastname: Shacham
authors.forename: Michael
authors.initials: M
authors.lastname: Donovan
authors.forename: Edgar Turner
authors.initials: ET
authors.lastname: Overton
mesh_terms: D000328:Adult; D000480:Alkynes; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D000069446:Atazanavir Sulfate; D048588:Benzoxazines / Q000627:therapeutic use*; D003521:Cyclopropanes; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1; D006801:Humans; D008297:Male; D009842:Oligopeptides / Q000627:therapeutic use*; D011725:Pyridines / Q000627:therapeutic use*; D012189:Retrospective Studies; D019438:Ritonavir / Q000627:therapeutic use*; D016896:Treatment Outcome; D019562:Viral Load; D055815:Young Adult
chemical_list: D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D003521:Cyclopropanes; D009842:Oligopeptides; D011725:Pyridines; D000069446:Atazanavir Sulfate; C098320:efavirenz; D019438:Ritonavir