TY - JOUR
T1 - Impact of body weight on virological and immunological responses to efavirenz-containing regimens in HIV-infected, treatment-naive adults
AU - Marzolini, Catia
AU - Sabin, Caroline
AU - Raffi, François
AU - Siccardi, Marco
AU - Mussini, Cristina
AU - Launay, Odile
AU - Burger, David
AU - Roca, Bernardino
AU - Fehr, Jan
AU - Bonora, Stefano
AU - Mocroft, Amanda
AU - Obel, Niels
AU - Dauchy, Frederic-Antoine
AU - Zangerle, Robert
AU - Gogos, Charalambos
AU - Gianotti, Nicola
AU - Ammassari, Adriana
AU - Torti, Carlo
AU - Ghosn, Jade
AU - Chêne, Genevieve
AU - Grarup, Jesper
AU - Battegay, Manuel
AU - AUTHOR GROUP
AU - Touloumi, Giota
AU - Warszawski, Josiane
AU - Meyer, Laurence
AU - Dabis, François
AU - Krause, Murielle Mary
AU - Leport, Catherine
AU - Reiss, Peter
AU - Wit, Ferdinand
AU - Prins, Maria
AU - Bucher, Heiner
AU - Gibb, Diana
AU - Fätkenheuer, Gerd
AU - del Amo, Julia
AU - Thorne, Claire
AU - Kirk, Ole
AU - Stephan, Christoph
AU - Perez-Hoyos, Santiago
AU - Hamouda, Osamah
AU - Bartmeyer, Barbara
AU - Chkhartishvili, Nikoloz
AU - Noguera-Julian, Antoni
AU - Antinori, Andrea
AU - D'Arminio Monforte, Antonella
AU - Brockmeyer, Norbert
AU - Prieto, Luis
AU - Conejo, Pablo Rojo
AU - Soriano-Arandes, Antoni
AU - van der Valk, Marc
PY - 2015
Y1 - 2015
N2 - Objective: The prevalence of overweight and obesity is increasing among HIV-infected patients. Whether standard antiretroviral drug dosage is adequate in heavy individuals remains unresolved. We assessed the virological and immunological responses to initial efavirenz (EFV)-containing regimens in heavy compared to normal-weight HIV-infected patients. Design: Observational European cohort collaboration study. Methods: Eligible patients were antiretroviral-naive with documented weight prior to EFV start and follow-up viral loads after treatment initiation. Cox regression analyses evaluated the association between weight and time to first undetectable viral load ( <50 copies/ml) after treatment initiation, and time to viral load rebound ( two consecutive viral load >50 copies/ml) after initial suppression over 5 years of follow-up. Recovery of CD4(+) cell count was evaluated 6 and 12 months after EFV initiation. Analyses were stratified by weight (kg) group (I - <55; II - > 55, <80 (reference); III > 80, <85; IV - > 85, <90; V - > 90, <95; VI - > 95). Results: The study included 19 968 patients, of whom 9.1, 68.3, 9.1, 5.8, 3.5, and 4.3% were in weight groups I-VI, respectively. Overall, 81.1% patients attained virological suppression, of whom 34.1% subsequently experienced viral load rebound. After multiple adjustments, no statistical difference was observed in time to undetectable viral load and virological rebound for heavier individuals compared to their normal weight counterparts. Although heaviest individuals had significantly higher CD4(+) cell count at baseline, CD4(+) cell recovery at 6 and 12 months after EFV initiation was comparable to normal-weight individuals. Conclusion: Virological and immunological responses to initial EFV-containing regimens were not impaired in heavy individuals, suggesting that the standard 600 mg EFV dosage is appropriate across a wide weight range. (C) 2015 Wolters Kluwer Health, Inc. All rights reserved
AB - Objective: The prevalence of overweight and obesity is increasing among HIV-infected patients. Whether standard antiretroviral drug dosage is adequate in heavy individuals remains unresolved. We assessed the virological and immunological responses to initial efavirenz (EFV)-containing regimens in heavy compared to normal-weight HIV-infected patients. Design: Observational European cohort collaboration study. Methods: Eligible patients were antiretroviral-naive with documented weight prior to EFV start and follow-up viral loads after treatment initiation. Cox regression analyses evaluated the association between weight and time to first undetectable viral load ( <50 copies/ml) after treatment initiation, and time to viral load rebound ( two consecutive viral load >50 copies/ml) after initial suppression over 5 years of follow-up. Recovery of CD4(+) cell count was evaluated 6 and 12 months after EFV initiation. Analyses were stratified by weight (kg) group (I - <55; II - > 55, <80 (reference); III > 80, <85; IV - > 85, <90; V - > 90, <95; VI - > 95). Results: The study included 19 968 patients, of whom 9.1, 68.3, 9.1, 5.8, 3.5, and 4.3% were in weight groups I-VI, respectively. Overall, 81.1% patients attained virological suppression, of whom 34.1% subsequently experienced viral load rebound. After multiple adjustments, no statistical difference was observed in time to undetectable viral load and virological rebound for heavier individuals compared to their normal weight counterparts. Although heaviest individuals had significantly higher CD4(+) cell count at baseline, CD4(+) cell recovery at 6 and 12 months after EFV initiation was comparable to normal-weight individuals. Conclusion: Virological and immunological responses to initial EFV-containing regimens were not impaired in heavy individuals, suggesting that the standard 600 mg EFV dosage is appropriate across a wide weight range. (C) 2015 Wolters Kluwer Health, Inc. All rights reserved
U2 - 10.1097/QAD.0000000000000530
DO - 10.1097/QAD.0000000000000530
M3 - Article
C2 - 25426810
SN - 0269-9370
VL - 29
SP - 193
EP - 200
JO - AIDS (London, England)
JF - AIDS (London, England)
IS - 2
ER -
SDG 3 Good Health and Well-being