Switch studies in virologically suppressed patients
Switch to ATV ± r-containing regimen
SLOAT
Original article : J Antimicrob Chemother. 2008 Jan;61(1):200-5 – V Soriano
Last update :
Epub 2007 Nov 13
Dr Anton Pozniak
Chelsea and Westminster Hospital
London, UK
- For patients with undetectable viraemia on a stable LPV/r-based regimen, replacement of LPV/r by ATV+r may provide:
- An overall reduction in fasting cholesterol and triglycerides
- No increased risk of virologic failure
-
Design :
Objective :
- Non inferiority in the proportion of patients with virologic rebound at W48 (upper limit of the 95% CI for the difference = 90%, 90% power)
- Virologic rebound: HIV-1 RNA > 50 c/mL
Baseline characteristics and patient disposition :
- PI use at screening was LPV/r: 37%, NFV: 33%, IDV/r: 10%, IDV: 8%, SQV/r: 6%, SQV: 3%
- TDF was part of the ARV regimen in 37 patients (9%) [26 in the ATV group]
Results: W48 outcome
Virologic failure
- Resistance mutations at virologic failure
- LPV/r: 1/9
- ATV: 2/5
- ATV/r: 3/7
- Median ATV Ctrough *
- ATV/r: 0.822 mg/L
- ATV: 0.234 mg/L
- Median CD4 increase between baseline and W48
- LPV/r: 46/mm3
- ATV+r: 42/mm3
* Effective minimal Ctrough = 0.15 mg/L
Metabolic parameters :
Use of lipid-lowering agents was more frequent in the LPV/r group: 17% vs 5% (p = 0.006)
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