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Protease Inhibitors...
Protease Inhibitors or NNRTIs as First-Line HIV-1 Treatment in West Africa (PIONA) : A Randomized Controlled Trial
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- Jespersen, Sanne (författare)
- Aarhus University Hospital,Bandim Health Project
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- Hønge, Bo Langhoff (författare)
- Bandim Health Project,Aarhus University Hospital
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- Krarup, Henrik (författare)
- Aalborg University
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- Medstrand, Patrik (författare)
- Lund University,Lunds universitet,Klinisk virologi, Malmö,Forskargrupper vid Lunds universitet,Clinical Virology, Malmö,Lund University Research Groups
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- Sørensen, Allan (författare)
- Bandim Health Project
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- Medina, Candida (författare)
- Ministry of Health, Guinea-Bissau
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- Té, David da Silva (författare)
- Ministry of Health, Guinea-Bissau
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- Correira, Faustino Gomes (författare)
- Ministry of Health, Guinea-Bissau
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- Erikstrup, Christian (författare)
- Aarhus University Hospital
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- Østergaard, Lars (författare)
- Aarhus University Hospital
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- Wejse, Christian (författare)
- Aarhus University,Bandim Health Project,Aarhus University Hospital
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- Laursen, Alex Lund (författare)
- Aarhus University Hospital
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(creator_code:org_t)
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- 2018
- 2018
- Engelska 8 s.
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Ingår i: JAIDS. - 1944-7884. ; 79:3, s. 386-393
- Relaterad länk:
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http://dx.doi.org/10...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- BACKGROUND: Nonnucleoside reverse transcriptase inhibitors (NNRTIs) are recommended as part of first-line treatment for HIV-1 in Africa. However, NNRTI-based regimens are more prone to resistance development than protease inhibitors (PIs) in a context in which drug interruptions are frequent. The aim of this study was to compare the efficacy and tolerability of NNRTIs with PIs in HIV-1-infected patients in Guinea-Bissau.METHODS: This open-label randomized, 2-arm superiority trial compared the use of 2 NRTIs plus either one NNRTI (efavirenz or nevirapine) or one PI (lopinavir/ritonavir) in treatment-naive HIV-1-infected adults in the Bissau HIV Cohort (ClinicalTrials.gov, NCT0019235). The primary endpoint was HIV-1 RNA <400 copies per milliliter after 12 months of treatment.RESULTS: Between May 5, 2011, and April 26, 2013, 400 patients were included in the study. In an intention-to-treat analysis, the proportions of patients with viral suppression were similar in the NNRTI [65/197 (33.0%)] and PI [68/203 (33.5%)] arms (P = 0.92). No PI resistance was detected, but high-level NNRTI resistance was seen in 17/30 (56.7%) of NNRTI vs. 3/26 (11.5%) of PI-treated patients, P < 0.01. After 1 year of follow-up, 65 patients died (16.3%) and 93 were lost to follow-up (23.3%). There was no difference in mortality (hazard ratio 0.84, 95% confidence interval: 0.51 to 1.36) or frequency of clinical adverse events between treatment arms [NNRTI: 73/197 (37.1%); and PI: 69/203 (34.0%); P = 0.52].CONCLUSIONS: In patients at an HIV clinic in Guinea-Bissau, treatment with PIs led to less development of resistance compared with NNRTIs but was not superior in terms of viral suppression, CD4 cell increment, mortality, or severe adverse events.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
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Jespersen, Sanne
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Hønge, Bo Langho ...
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Krarup, Henrik
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Medstrand, Patri ...
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Sørensen, Allan
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Medina, Candida
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Té, David da Sil ...
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Correira, Fausti ...
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Erikstrup, Chris ...
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Østergaard, Lars
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Wejse, Christian
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Laursen, Alex Lu ...
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