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Abstract
Reduced rates of viral load suppression at six to 12 months by saquinavir and nelfinavir are not solely explained by reduced adherence to therapy.
Moore D.1, Hogg R.1, Yip B.1, Wood E.1, Montaner J.1
Objective: To examine whether variations in viral load suppression with the use of individual protease inhibitor drugs are explained by variations in adherence to therapy.
Methods: Treatment-naïve individuals who initiated triple combination therapy with a PI between August 1, 1996 and June 30, 2002 and had at least one viral load measured six to 12 months after, were enrolled in a population-based cohort in British Columbia, Canada. Chi-squared and Kruskal-Wallis tests were used to compare baseline variables across treatment groups. Logistic regression analysis was used to examine associations between achieving a viral load of < 500 copies/ mL, use of five individual PI drugs and other baseline factors thought to be associated with viral load suppression.
Results: A total of 647 (64%) subjects initiated therapy with indinavir, 97 (9.6%) with saquinavir, 52 (5.1%) with lopinavir, 186 (18%) with nelfinavir and 30 (3.0%) with ritonavir only. Study subjects differed from each other by assigned drug on the basis of age, history of injection drug use, proportion with AIDS at baseline, and baseline CD4 count strata (p values < 0.05, for all). The proportion of subjects achieving a viral load of <500 copies/mL was 69.6% for indinavir, 52.6 % for saquinavir, 82.7% for lopinavir, 64.0% for nelfinavir, and 63.3% for ritonavir-only (p value < 0.05). In multivariate analysis after adjustment for age, gender, history of IDU, having AIDS at baseline, and baseline CD4 count strata, saquinavir (RR = 0.42; 95% CI 0.26 - 0.65) and nelfinavir (RR = 0.65; 95% CI 0.45 -0.93) were significantly less likely to achieve viral load suppression when compared to indinavir. Further adjustment for adherence to therapy did not significantly alter these results.
Conclusions: Saquinavir and nelfinavir were less likely to achieve viral load suppression compared to other PIs. This was not solely accounted for by differences in adherence to therapy.
The 3rd IAS Conference on HIV Pathogenesis and Treatment
Abstract no.
WePe12.7C15
Suggested Citation
"MooreD., et al.
Reduced rates of viral load suppression at six to 12 months by saquinavir and nelfinavir are not solely explained by reduced adherence to therapy..
Poster Exhibition:
The 3rd IAS Conference on HIV Pathogenesis and Treatment:
Abstract no.
WePe12.7C15"
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