Long-term treatment with atazanavir (ATV) in real life in Belgium: a retrospective observational cohort of 2264 HIV patients

Abstract

Objectives This 5-year follow-up study aimed to assess clinical outcomes of HIV-1 infected adults treated with atazanavir (ATV) in clinical practice in Belgium, to describe patient profiles and characteristics, as well as treatment safety. Methods A multicenter, non-interventional, non-comparative, retrospective cohort study was performed in HIV-1 positive adult patients treated with ATV between 2006 and 2012. Data were collected from 8 AIDS reference centers' databases. All analyses were on-treatment. Sub-analyses were carried out in unboosted ATV treated patients and in females. The primary endpoint was defined as the time-to-treatment-discontinuation. Furthermore, virological suppression, immunological response, time to loss of virological response, reasons for ATV initiation, and discontinuation were also assessed. Results 2264 ARV-naive and ARV-experienced patients (median age: 41 years) were included. Females and non-Caucasians were broadly represented (40 and 45%, respectively). The probability to remain on treatment was 0.78 (CI: 0.76; 0.78) for the first and 0.69 (CI: 0.66; 0.71) for the second year and was similar between males and females. Overall, 771 patients (34.1%) discontinued ATV over time, the median (Q1-Q3) time to discontinuation being 0.8 (0.3-1.5) year. In unboosted ATV-treated patients, results were comparable to the overall ATV population, except for a higher rate of discontinuation-over-time (45.1%). Conclusions Clinical and safety data from this 5 year-cohort study show that the vast majority of patients remained on ATV treatment for the first and second years, overall as well as patients treated with unboosted ATV and females.

Long-term effectiveness of unboosted atazanavir plus abacavir/lamivudine in subjects with virological suppression

“…The regimen also showed a good safety profile, supporting previous similar findings. [ 19 , 20 ] We found no significant differences regarding sex in the multivariable analysis.…”

“…[ 24 ] Some studies included treatment-naïve patients in the analysis. [ 20 ] Others included patients with detectable plasma HIV-1 viral load (pVL) at baseline, or had a short follow-up, or a small sample size with a mix of subjects also treated with ATV/r. [ 14 , 19 , 21 , 23 ] Finally, most studies included patients with unknown HLA-B∗5701 status, and could have a higher rate of discontinuation due to suspected abacavir hypersensitivity reactions.…”