Abacavir/lamivudine plus darunavir/ritonavir in routine clinical practice: a multicentre experience in antiretroviral therapy-naive and -experienced patients.
OBJECTIVE
To present clinical experience with a regimen including abacavir/lamivudine + darunavir/ritonavir in a cohort of HIV-1-infected patients.


METHODS
A retrospective, multicentre cohort study, including all consecutive adult HIV-1-infected patients who started abacavir/lamivudine + darunavir/ritonavir from April 2008 to December 2010 and had at least one follow-up visit. The primary endpoint was HIV-1 viral load (VL) <40 copies/mL at week 48.


RESULTS
One hundred and eighty-three patients (42 naive and 141 experienced) from 19 hospitals in Spain were studied. The median follow-up was 26.7 (0.5-58.6) months, 79.8% were men, the median age was 47.1 (21.4-80.5) years, 26.2% had AIDS and 38.8% were positive for hepatitis C virus. At baseline, the median CD4 count was 246 cells/mm(3) in naive patients and 393 cells/mm(3) in experienced patients and the median VL was 4.80 and <1.59 log copies/mL, respectively. At week 48, 81.8% of naive patients and 84.2% of experienced patients receiving the regimen reached a VL <40 copies/mL, whereas at 96 weeks this occurred in 90.5% and 92.8%, respectively. CD4 cell count increases at 48 and 96 weeks were +176.5 and +283.5 cells/mm(3) in naive patients and +74.9 and +93 cells/mm(3) in experienced patients, respectively. Overall, 86 (47%) patients discontinued the study regimen, in many cases possibly related to non-medical reasons, such as drug switches to reduce cost or changes in address due to economic constraints. Three patients died of causes unrelated to therapy and 19 (10.4%) discontinued the regimen due to adverse events.


CONCLUSIONS
In our cohort, abacavir/lamivudine + darunavir/ritonavir was safe, well tolerated and achieved high rates of virological suppression. In a proportion of patients, discontinuation of this effective regimen was possibly due to non-medical reasons.
Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain dpodzamczer@bellvitgehospital.cat.
D
D
Podzamczer
Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
A
A
Imaz
Hospital Clínic, Barcelona, Spain.
I
I
Perez
Hospital Virgen del Rocío, Sevilla, Spain.
P
P
Viciana
Hospital Carlos III, Madrid, Spain.
E
E
Valencia
Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
J
J
Curto
Hospital Puerta de Hierro, Majadahonda, Spain.
T
T
Martín
Hospital Carlos Haya, Málaga, Spain.
M
M
Castaño
Hospital Clínic, Barcelona, Spain.
J
J
Rojas
Hospital Virgen del Rocío, Sevilla, Spain.
N
N
Espinosa
Hospital Carlos III, Madrid, Spain.
V
V
Moreno
Hospital Universitario Central de Asturias, Oviedo, Spain.
V
V
Asensi
Hospital Universitario Donostia, San Sebastián, Spain.
J A
JA
Iribarren
IrsiCaixa, Hospital Universitari 'Germans Trias i Pujol', Badalona, Spain Universitat Autònoma de Barcelona, Barcelona, Spain Universitat de Vic, Catalonia, Spain.
B
B
Clotet
Hospital de Mataró, Mataró, Spain.
L
L
Force
Hospital Universitario Rio Ortega, Valladolid, Spain.
P
P
Bachiller
Hospital del Mar, Barcelona, Spain.
H
H
Knobel
Hospital General Universitario Gregorio Marañón, Madrid, Spain.
J C
JC
López Bernaldo De Quirós
Hospital San Pedro, Logroño, Spain.
J R
JR
Blanco
Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
N
N
Rozas
Hospital Clínico San Carlos, Madrid, Spain.
J
J
Vergas
Hospital Xeral Cies, Vigo, Spain.
A
A
Ocampo
Hospital Reina Sofía, Córdoba, Spain.
A
A
Camacho
Hospital Arnau de Vilanova, Valencia, Spain.
J
J
Flores
Hospital Universitario de Canarias, La Laguna, Spain.
J L
JL
Gomez-Sirvent
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects / Q000379:methods*; D015331:Cohort Studies; D000069454:Darunavir; D015224:Dideoxynucleosides / Q000009:adverse effects / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1 / Q000302:isolation & purification; D006801:Humans; D019259:Lamivudine / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D019438:Ritonavir / Q000009:adverse effects / Q000627:therapeutic use*; D013030:Spain; D013449:Sulfonamides / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D019562:Viral Load; D055815:Young Adult; D000099227:Abacavir
D019380:Anti-HIV Agents; D000069454:Darunavir; D015224:Dideoxynucleosides; D004338:Drug Combinations; D019259:Lamivudine; D019438:Ritonavir; D013449:Sulfonamides; C492871:abacavir, lamivudine drug combination; D000099227:Abacavir
HIV treatment; protease inhibitors; viral response