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Abacavir/lamivudine has shown similar efficacy to other nucleoside conventional combinations in previously HIV-infected patients: results at 48 weeks

Purpose of the study

Controversial data have been recently published with respect to the antiviral response to abacavir(ABC)/lamivudine(3TC) (Kivexa®). We compared the efficacy and safety of efavirenz(EFV)+abacavir(ABC)/lamivudine(3TC) (Kivexa®) with other conventional regimens of 2NRTI+efavirenz(EFV).

Methods

A multicenter, prospective and randomized study was performed in 19 centres located in Spain (18) and Italy (1). Patients in treatment with 2NRTI+EFV and viral suppression over ≥6 months were randomized to ABC/3TC (Kivexa®)+ EFV (Group A) or to continue the same regimen 2NRTI+EFV (Group B) and followed every 3 months until 48 weeks. Mann-Whitney test (non-parametric test) was used to compare between continuous variables.

Summary of results

A total of 100 patients were included in this study: 51 of them in Group A and 49 in Group B. Both groups were comparable for all baseline variables. Only one patient from Group A presented viral rebound at 24 weeks. No statistically significant changes from baseline in CD4+ cell count were seen at week 48 in either group: 528 cell/mm3 (± 252) to 592 (± 266) in Group A and 644 (± 265) to 627 (± 224) in Group B, (p = 0.311 between groups) at week 48. Total cholesterol showed a slight increase only at week 24 in Group A (from 198 mg/dl ± 43 to 214 ± 39, p = 0.014) and in Group B (200 mg/dl ± 50 to 194 ± 53; p = 0.036) without any difference at week 48. Drug discontinuation for toxicity was higher in Group A (seven subjects (7%), five of them for hypersensitivity reaction) than in Group B (only two patients).

Conclusion

ABC/3TC (Kivexa®), in combination with EFV, was a good alternative as a simplification regimen due to its virological and immunological effectiveness and good tolerability. Nowadays, the availability of a genetic test (HLA B*57) will reduce the incidence of discontinuation due to hypersensitivity reaction.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Echeverría, P., De la Torre, J., Pasquau, J. et al. Abacavir/lamivudine has shown similar efficacy to other nucleoside conventional combinations in previously HIV-infected patients: results at 48 weeks. JIAS 11, P65 (2008). https://doi.org/10.1186/1758-2652-11-S1-P65

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  • DOI: https://doi.org/10.1186/1758-2652-11-S1-P65

Keywords

  • Cholesterol
  • Genetic Test
  • Nucleoside
  • Lamivudine
  • Hypersensitivity Reaction