title: Week 120 efficacy of tenofovir, lamivudine and lopinavir/r-based second-line antiretroviral therapy in treatment-experienced HIV patients.
abstract: BACKGROUND
  Tenofovir (TDF) and ritonavir-boosted lopinavir (LPV/r) were not introduced to China as second-line medications until 2009. The efficacy and safety of TDF/3TC/LPV/r based second-line regimen have not been evaluated in Chinese HIV patients who failed first-line regimens.
  
  
  METHODS
  This was a multicenter cohort study recruiting patients from Beijing, Shanghai, Guangdong, and Henan provinces between November 2008 and January 2010. Eighty HIV infected patients failing first-line regimens with serum creatinine lower than 1.5 times the upper limit of normal received TDF+ lamivudine (3TC)+ LPV/r were followed up for 120 weeks. CD4 cell count, viral load, and estimated glomerular filtration rate (eGFR) were monitored at each visit.
  
  
  RESULTS
  At baseline, 31.2% and 48.8% of patients had moderate/high-level resistance to TDF and 3TC, respectively; while 2.5% of patients had only low-level resistance to LPV/r. During 120 weeks of follow-up, virological suppression rate reached over 70% (<40 copies/ml) and 90% (<400 copies/ml), and median CD4 cell count increased from 157 cells/μL at baseline to 307 cells/μL at week 120. Baseline drug-resistance mutations had no impact on the efficacy of second-line antiretroviral therapy. Median eGFR dropped from 104.7 ml/min/1.73m2 at baseline to 95.6 ml/min/1.73m2 at week 24 and then recovered after week 96.
  
  
  CONCLUSIONS
  This study for the first time demonstrated that TDF+ 3TC+ LPV/r was efficacious as second-line regimen with acceptable nephrotoxicity profiles in patients who failed zidovudine or stavudine based first-line regimens in China.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT00872417.
authors.affiliation: Department of Infectious Diseases, Peking Union Medical College Hospital, Beijing, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Han
authors.affiliation: Department of Infectious Diseases, Peking Union Medical College Hospital, Beijing, China.
authors.forename: Yijia
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Infectious Diseases, Peking Union Medical College Hospital, Beijing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Xie
authors.affiliation: Department of Infectious Diseases, Peking Union Medical College Hospital, Beijing, China.
authors.forename: Zhifeng
authors.initials: Z
authors.lastname: Qiu
authors.affiliation: Department of Infectious Diseases, Peking Union Medical College Hospital, Beijing, China.
authors.forename: Yanling
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Infectious Diseases, Peking Union Medical College Hospital, Beijing, China.
authors.forename: Xiaojing
authors.initials: X
authors.lastname: Song
authors.affiliation: Department of Infectious Diseases, Peking Union Medical College Hospital, Beijing, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Zhu
authors.affiliation: Department of Infectious Diseases, Peking Union Medical College Hospital, Beijing, China.
authors.forename: Taisheng
authors.initials: T
authors.lastname: Li
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D018791:CD4 Lymphocyte Count / Q000379:methods; D002681:China; D015331:Cohort Studies; D024882:Drug Resistance, Viral / Q000187:drug effects; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000627:therapeutic use*; D015497:HIV-1 / Q000187:drug effects; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D061466:Lopinavir / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D019438:Ritonavir / Q000627:therapeutic use; D000068698:Tenofovir / Q000627:therapeutic use*
chemical_list: D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors; D061466:Lopinavir; D019259:Lamivudine; D000068698:Tenofovir; D019438:Ritonavir
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