Press N, Woods R, Raboud J, Harrigan PR, Montaner JG; Conference on Retroviruses and Opportunistic Infections; The INCAS AVANTI and CNAAB3005 Study Teams.

9th Conf Retrovir Oppor Infect Feb 24 28 2002 Wash State Conv Trade Cent Seattle Wash Conf Retrovir Oppor Infect 9th 2002 Seattle Wash. 2002 Feb 24-28; 9: abstract no. 419-W.

Canadian HIV Trials Network, Vancouver, BC, Canada

BACKGROUND: The purpose of this study was to compare the characteristics of virologic rebounds in HIV-1-infected patients on various HAART regimens.METHODS: Individual patient data were compared from the triple regimen arms of 4 completed clinical trials (INCAS: AZT/ddI/NVP, n=51; AVANTI-2: AZT/3TC/IND, n=52; AVANTI-3: AZT/3TC/NFV, n=53; and CNAAB3005: AZT/3TC/ABC, n=262). HIV-1 RNA levels were performed in prospectively collected samples after completion of each trial, and thus were not available for use in patient management. Rebound was defined in patients who achieved viral suppression as 2 consecutive HIV-1 RNA values above the lower limit of quantification (LLOQ for INCAS, AVANTI-2, AVANTI-3 was 50 copies/mL, and for CNAAB3005 was 400 copies/mL). The triple drug regimens from the 4 clinical trials were compared for predictors of rebound, time to rebound and slope of rebound, using a logistic regression model, Cox proportional-hazards model and linear regression model, respectively.RESULTS: The NVP-containing regimen had the steepest slope of viral rebound (p=0.006) using the LLOQ of each trial. Even when 400 copies/mL was used as the LLOQ for all the trials, the NVP-containing regimen maintained a trend for steepest slope of rebound (p=0.065). A NVP-containing regimen did not influence time to rebound (p=0.63). Non-adherence was a predictor of viral rebound (OR 3.1, p=0.0001), a shorter time to rebound (RR 3.66, p=0.0001), and a steeper slope of rebound (p=0.04). Occurrence of a single detectable HIV-1 RNA (blip), baseline CD4 count and baseline viral load were not predictive of rate of viral rebound or slope of rebound.CONCLUSIONS: Patients taking NVP-containing regimens showed a steeper slope of rebound than patients taking PI or ABC-containing regimens. The non-NVP regimens all contained 3TC, hence differences in early virologic rebound could be related to the emergence of the M184V mutation vs the K103N or Y181C mutation in the NVP regimen.

Publication Types:

• Meeting Abstracts

Keywords:

• AIDS Vaccines
• Acquired Immunodeficiency Syndrome
• Anti-HIV Agents
• Antiretroviral Therapy, Highly Active
• CD4 Lymphocyte Count
• Clinical Protocols
• Clinical Trials as Topic
• Didanosine
• Drug Therapy, Combination
• HIV
• HIV Infections
• HIV Protease Inhibitors
• HIV Seropositivity
• HIV-1
• Humans
• Lamivudine
• Viral Load
• Zidovudine
• drug therapy
• therapy

Other ID:

• GWAIDS0024232

UI: 102263856

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