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CD4 Cell Recovery in HIV-1 Patients Comparing 2 Treatment Regimes

2014-08-27 03:19:45 | BioPortfolio

Summary

Therapy guidelines recommend the use of either the non-nucleoside reverse transcriptase inhibitor (NNRTI) efavirenz or a ritonavir-boostered protease inhibitor (PI) plus 2 nucleoside reverse transcriptase inhibitors (NRTI) as first-line treatment regimes of HIV-1 infection. Recent clinical studies suggest potential advantages of NNRTI- over PI-based regimes in therapy initiation due to lower rates of virologic failure and less metabolic side-effects. In contrast, PI regimes were claimed to cause greater increases in CD4 cell count than NNRTI regimes, which has been attributed to intrinsic antiapoptotic effects of the PI. However, it is still unclear whether the immunological response to a PI-containing regime is greater than to an NNRTI-containing regime, whether there is a difference in the extent of reduction of apoptosis between PI and NNRTI regimes and whether a difference in apoptosis is associated with a difference in CD4 cell recovery.

We conducted a controlled, long-term, random matched pair design study in HIV-1 infected individuals under sustained virologic suppression to evaluate in head-to-head comparison the clinical effects of a constant PI-based or NNRTI-based regime on CD4 cell recovery and the underlying molecular, biochemical and functional mechanisms.

Study Design

Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Single Blind (Investigator), Primary Purpose: Treatment

Conditions

Acquired Immunodeficiency Syndrome

Intervention

Lopinavir/Ritonavir plus Lamivudine/Zidovudine, Efavirenz plus Lamivudine/Zidovudine

Location

Medical Clinic I and Department of Pharmacology, University of Cologne
Cologne
Germany

Status

Completed

Source

University of Cologne

Results (where available)

View Results

Links

Published on BioPortfolio: 2014-08-27T03:19:45-0400

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Medical and Biotech [MESH] Definitions

A reverse transcriptase inhibitor and ZALCITABINE analog in which a sulfur atom replaces the 3' carbon of the pentose ring. It is used to treat HIV disease.

An HIV protease inhibitor used in a fixed-dose combination with RITONAVIR. It is also an inhibitor of CYTOCHROME P-450 CYP3A.

An HIV protease inhibitor that works by interfering with the reproductive cycle of HIV.

Inhibitor or Reverse Transcriptases or of RNA-dIrected DNA polymerase.

A cytochrome P450 enzyme subtype that oxidizes a diverse array of XENOBIOTICS. The expression of CYP2B6 varies widely between individuals which is due to the high rate of GENETIC POLYMORPHISMS. Examples of drugs metabolized by CYP2B6 include BUPROPION; efavirenz; CYCLOPHOSPHAMIDE; and MEPERIDINE.

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