Efficacy and Tolerability of Lopinavir/Ritonavir- and Efavirenz-Based Initial Antiretroviral Therapy in HIV-1-Infected Patients in a Tertiary Care Hospital in Beijing, China

• Published in: Frontiers in pharmacology Vol. 10; p. 1472
• Main Authors: Su, Bin, Wang, Yin, Zhou, Ruifeng, Jiang, Taiyi, Zhang, Hongwei, Li, Zaicun, Liu, An, Shao, Ying, Hua, Wei, Zhang, Tong, Wu, Hao, He, Shenghua, Dai, Lili, Sun, Lijun
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 12.12.2019
• Subjects: adverse effects; antiretroviral therapy; efavirenz; first-line therapy; human immunodeficiency virus; lopinavir/ritonavir; Pharmacology; lopinavir/ritonavir; adverse effects; human immunodeficiency virus; first-line therapy; antiretroviral therapy; efavirenz
• ISSN: 1663-9812; 1663-9812
• DOI: 10.3389/fphar.2019.01472

Lopinavir/ritonavir (LPV/r) is a major antiretroviral treatment in China, but little is known about the performance of first-line LPV/r-based regimen in treatment-naïve patients with human immunodeficiency virus type 1 (HIV-1) infection. This study aims to assess the efficacy and adverse effect events of LPV/r plus lamivudine and tenofovir or zidovudine as an initial antiretroviral treatment in HIV-1-infected individuals for whom cannot take efavirenz (EFV) or is allergic to EFV. We performed a retrospective study of patients registering with the China's National Free Antiretroviral Treatment Program from July 2012 to January 2017, followed at a tertiary care hospital in Beijing, China. The primary outcome was the proportion of subjects with HIV-1 RNA ≤40 copies/ml at 6 and 24 months of treatment. We assessed the immunological response and adverse events. In total, 4,862 patients were enrolled in the study and 237 were eligible for analysis in each study arm. During the first six months, virological suppression was better with the LPV/r-based regimen than with the EFV-based regimen (93.80 vs 87.80% for < 0.05). Viral suppression rates continued to increase until 12 months, remain steady thereafter until 24 months, for both groups. The multilevel analysis revealed that patients in the LPV/r group were more likely to display improvements in CD4 T-cell count over time than those in the EFV group ( < 0.001). Grade 3 or 4 laboratory adverse events were observed in 14 patients (5.91%) from the LPV/r group and three patients (1.20%) in EFV group. Our findings demonstrate that LPV/r-containing regimens are effective and well-tolerated in Chinese treatment-naïve patients with HIV-1 infection.