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

Abstract

Background: 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. Methods: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.Results: 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 P < 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 (P < 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.Conclusion: Our findings demonstrate that LPV/r-containing regimens are effective and well-tolerated in Chinese treatment-naïve patients with HIV-1 infection.

Clinical characteristics and therapeutic procedure for four cases with 2019 novel coronavirus pneumonia receiving combined Chinese and Western medicine treatment

“…By February 4, 2020, two patients were confirmed 2019-nCoV negative and one patient was virus-negative at the first test. Lopinavir/ ritonavir (Kaletra ® ) is a human immunodeficiency virus (HIV) medicine used in combination with other medicines to treat adults and children over 14 days of age who are infected with HIV-1 (7). It was revealed that lopinavir/ritonavir among SARS-CoV patients was associated with substantial clinical benefit (fewer adverse clinical outcomes) (8).…”

A comparative‐descriptive analysis of clinical characteristics in 2019‐coronavirus‐infected children and adults

“…11 Lopinavir and Ritonavir are anti-human immunodeficiency virus (HIV) protease inhibitor, which are also used to treat HIV-1 in adults and children above 14 days of age. 22 That fewer adverse clinical outcomes were reported among SARS-CoV patients revealed that lopinavir/ritonavir benefited the patients in clinical practice substantially. 23 None of the 32 patients required intensive care or mechanical ventilation or had any severe complications.…”

Innate immunity in COVID-19 patients mediated by NKG2A receptors, and potential treatment using Monalizumab, Cholroquine, and antiviral agents

“…Interferon-α is a broad-spectrum antiviral drug previously used for viral hepatitis, and could also potentially block viral replication of SARS-COV [22]. Lopinavir/ritonavir are antiviral agents used in treating Human Immunodeficiency Virus (HIV) infections [23], and are HIV protease enzyme inhibitors that result in the formation of non-infectious viral particles. Lopinavir/ritonavir have shown anti-SARS-CoV activity in clinical trials and in vitro studies [24].…”