- Poster presentation
- Open Access
Tolerance and durability of abacavir/lamivudine (ABC/3TC)-containing regimens: results from a large prospective French cohort
© Allavena et al; licensee BioMed Central Ltd. 2010
- Published: 8 November 2010
- Liver Disease
- Cardiovascular Event
- Treatment Failure
- Median Duration
- Treatment Discontinuation
Patients (pts) were selected from the Dat'AIDS French prospective cohort if they were prescribed an ABC/3TC containing regimen for the first time between 01/01/2004 and 31/12/2007 and were still actively followed on 31/05/2008 as to ensure sufficient follow-up. All causes of treatment discontinuation were recorded, as well as immuno-virological data and cardiovascular events (CE) during follow-up.
Among the 1704 pts included in the study (male 70%, mean age 43 years, HBV or HCV co-infection 24.1%) 407 (24%) were antiretroviral (ARV) naïve, 696 (41%) were virologically controlled on ARV treatment (switch), and 601 (35%) were on treatment with detectable VL (failure) at time of ABC/3TC initiation. Previous treatment with 3TC was noted in 92% of the pretreated pts. With a median duration of follow-up of 496 days, the population represents 2636 pts-year.
Overall 565pts (33%) discontinued ABC/3TC combination during follow-up (36%, 24%, and 42% of the naive, switch and failure groups, respectively). Reasons for discontinuation were poor tolerance in 41% of the cases, including suspected hypersensitivity (HSR) in 4% of the overall population, treatment failure in 20%, and other causes in 39%. This distribution was not different if pts received either a NNRTI (20% of the pts) or a boosted protease inhibitor (46%) in their regimen. Median time to discontinuation was 4.3 years overall and less than one month in case of suspected HSR. Discontinuation for bad tolerance was observed in 38%, 54%, and 35% of the naïve, switch and failure populations respectively, whereas treatment failure was responsible for discontinuation in 15%, 10%, and 29% of the same populations. Major CE were reported in 21 cases (0.08% py). Death was recorded in 27 cases, 9 deaths being AIDS related, 6 related to liver diseases, 6 to cancer, 2 to vascular accidents (1 cardiac, 1 neurological), 1 accidental, and 3 unknown. At M24, probability of still receiving ABC/3TC was 62%, 77%, and 60% respectively for the defined groups, and VL on treatment was below detection for 86%, 90%, and 71% of them, respectively.
In this population of pts who received ABC/3TC containing regimens before HLA screening was routinely available, treatment was maintained with virological success for more than 2 years. Poor tolerance was the main reason for early discontinuation, and was not different if the pts received either NNRTI or boosted PI in their regimen. CE were rare.
This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.