Efficacy and safety of tenofovir/emtricitabine compared to abacavir/lamivudine in HIV-1 infected patients in clinical setting. The TEAL study

Background

Limited direct comparative data exist between the recommended dual NRTI fixed dose combinations, tenofovir/emtricitabine (Truvada) and abacavir/lamivudine (Kivexa). A recent study (HEAT) evaluated these dual NRTI backbones with a boosted PI. However, there are no data comparing these two formulations when used with other antiretroviral drugs.

Methods

Retrospective study of HIV-1 infected patients in two Genito-Urinary Medicine clinics. Patients taking either Truvada or Kivexa were included. Data including previous treatment, resistance test, HLA B5701 status, pre-treatment CD4 count, plasma viral load, age, ethnicity, renal function, lipid profiles were gathered. Primary endpoint was the proportion of subjects with viral load <50 copies/ml at 48 weeks.

Summary of results

232 patients were included, of which 129 were on Truvada and 103 on Kivexa; 114 were treatment naive. (Tables 1 and 2.)

Table 1

Table 2 Week 48 results (ITT-E, Missing = excluded).

Conclusion

Truvada was non-inferior to Kivexa in this cohort. However, virological failure was observed in three patients when Kivexa was used with an NNRTI. Median CD4 increase was greater in Truvada arm at 48 weeks but this was not statistically significant. Further data will be presented at the meeting.