Long-Term
Follow Up of Abacavir/Lamivudine/Zidovudine (Trizivir) Compared to Standard NNRTI-containing
Regimens in Treatment-naive Patients
After
AZT-3TC-ABC
(Trizivir) showed inferior results in treatment-naïve
patients compared to efavirenz (Sustiva)-
containing regimens at week 26, use of 3 NRTI as initial treatment has been discouraged. Between
2000-2004, several patients
started with Trizivir. The current study evaluates their
long-term outcome in comparison to NNRTI
containing regimens. In
the ATHENA cohort, all naïve patients were selected who started AZT-3TC combined
with abacavir/ABC (Ziagen), nevirapine (NVP) or efavirenz (EFZ). Over time,
virological success and other parameters were analyzed. Results 
Between 2000 and 2004, 1079 naive patients
started HAART with AZT-3TC-ABC (n=200), AZT-3TC-EFZ (n=384) or AZT-3TC-NVP (n=495).
At
baseline, a significantly higher proportion of patients in the EFZ group had CDC-C
criteria, with higher BL viral loads and lower CD4 counts.
Within
a median follow-up of 29.4 months, 534/1079 patients changed / stopped the initial
treatment with no significant difference in time to regimen change between the
three groups.
Most important reason to stop/change
treatment < 2 years was toxicity (ABC-group = 36/90(40%), EFZ group = 89/164 (54%), NVP group
=108/216 (50%), but time to such change did not differ significantly between treatment
groups.
Time to virological suppression < 50 cps/ml was not significantly different.
Time
to viral rebound >50 copies/ml was significantly shorter in patients starting
Trizivir compared to NVP (acceleration factor 3.19 (1.24,
8.33, p=0.02) but not to EFZ.
The
authors conclude, “Virological success between the three regimens was not significantly
different, but there was a higher virological failure
rate in ABC vs NVP arm.” 01/13/06 Reference
G E L Van den Berk and others.
Long-Term Follow Up of Abacavir-Lamivudine-Zidovudine
Compared to Standard NNRTI Containing Regimens in Antiretroviral Naive Patients.
Abstract H-518. Abstracts
of the 45th Interscience Conference on
Antimicrobial Agents and Chemotherapy. December 16-19, 2005. Washington, DC.
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