Author(s): Gathe JC Jr, Ive P, Wood R, Schrmann D, Bellos NC, , Gathe JC Jr, Ive P, Wood R, Schrmann D, Bellos NC,
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Abstract OBJECTIVE: To compare the magnitude and durability of the antiviral response to fosamprenavir (FPV) plus ritonavir (RTV) once-daily (FPV/r QD) with nelfinavir twice-daily (NFV BID), each administered with abacavir and lamivudine twice-daily. METHODS: An international, phase III, randomized, open-label study in antiretroviral therapy-naive, HIV-infected adults. RESULTS: Patients with advanced HIV disease received FPV/r QD (n = 322) or NFV BID (n = 327). At week 48, 69\% of patients in the FPV/r QD group and 68\% in the NFV BID group had plasma HIV-1 RNA (vRNA) < 400 copies/ml, whereas 55\% of patients in the FPV/r QD group and 53\% in the NFV BID group had vRNA < 50 copies/ml (intent to treat, rebound/discontinuation = failure). More patients in the NFV BID group (17\%) experienced virological failure than in the FPV/r QD group (7\%). Efficacy of FPV/r QD was maintained in patients with CD4+ cell counts < 50 x 10 cells/l or vRNA >/= 100 000 copies/ml at entry. At week 48, median CD4+ cell counts were increased to 203 x 10 cells/l (FPV/r QD group) and 207 x 10 cells/l (NFV BID group). Both regimens were generally well tolerated. Diarrhea was more common on NFV BID than on FPV/r QD (16 versus 9\%; P = 0.008). Fasting lipid profile results were generally favorable in both treatment arms. FPV/r QD maintained plasma amprenavir (APV) trough concentrations above the mean phenotypic drug-susceptibility (IC50) for wild-type virus for APV. CONCLUSION: As a first choice protease inhibitor with a low daily pill burden, FPV/r QD was well tolerated and provided potent, durable antiviral suppression.
This article was published in AIDS
and referenced in Journal of AIDS & Clinical Research