Single-tablet regimen is associated with reduced efavirenz withdrawal in antiretroviral naïve or switching for simplification HIV-infected patients


of results Overall, 533 patients, starting EFV-containing regimen from May 1998 to March 2012, were included (51.2% naı̈ve, 48.8% switched). Patients characteristics: males 70.7%, median age 39 years, injecting drug use (IDU) 11.2%, median nadir CD4 194/ mmc, median CD4 at EFV start 305/mmc: 38.7% started BID regimen, 43.9% OD regimen and 17.4% STR. At survival analysis, the overall proportion of EFV interruption was 19.1% at 1 year and 33.0% at 3 years; interruption for virological failure were 2.8% and 7.4% and for toxicity 10.2% and 15.9%, respectively. CNS-SE accounted for about half of interruptions for toxicity (5.7% and 8.0% at 1 and 3 years, respectively). Naı̈ve patients had a higher risk of interruption as compared to switched patients: 37.7% vs. 28.0% at 3 years (p 0.06). While no significant difference was observed comparing OD vs. B ID regimens, starting with STR was associated with significant lower proportion of overall interruption at 3 years (17.1% vs. 36.6%, pB0.01). No virological failure was observed with STR up to 3 years (0.0% vs. 8.9%, p 0.05); no difference of interruption by overall toxicity and higher, though non-significant, frequency of interruption by CNS-SE (12.8% vs. 6.8%) were also observed. STR also accounted for lower proportion of interruption by patient wish, including low adherence (1.5% vs. 12.3%, p 0.01). At adjusted Cox model, STR (HR: 0.44; 95% CI: 0.26 0.77) and male gender (HR: 0.71; 95% CI: 0.53 0.97) were associated with lower risk of EFV interruption and IDU with higher risk (HR: 1.64; 95% CI: 1.11 2.42).

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@inproceedings{Fabbiani2012SingletabletRI, title={Single-tablet regimen is associated with reduced efavirenz withdrawal in antiretroviral na{\"{i}ve or switching for simplification HIV-infected patients}, author={Massimiliano Fabbiani and Pierfrancesco Grima and Mariella Prosperi and Iuri Fanti and Manuela Colafigli and Mauro Zaccarelli and Alessandro D'Avino and Annalisa Mondi and Alberto Borghetti and Massimo Fantoni and Roberto Cauda and Simona di Giambenedetto}, year={2012} }