An observational study in an urban Ugandan clinic comparing virological outcomes of patients switched from first-line antiretroviral regimens to second-line regimens containing ritonavir-boosted atazanavir or ritonavir-boosted lopinavir
Abstract Background The World Health Organisation approved boosted atazanavir as a preferred second line protease inhibitor in 2010. This is as an alternative to the current boosted lopinavir. Atazanavir has a lower genetic barrier than lopinavir. We compared the virological outcomes of patients dur...
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BMC
2019-03-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | http://link.springer.com/article/10.1186/s12879-019-3907-5 |
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| author | Eva Agnes Odongpiny Laker Maria Sarah Nabaggala Arvind Kaimal Damalie Nalwanga Barbara Castelnuovo Abdu Musubire Agnes Kiragga Mohammed Lamorde Rosalind Parkes- Ratanshi |
| author_facet | Eva Agnes Odongpiny Laker Maria Sarah Nabaggala Arvind Kaimal Damalie Nalwanga Barbara Castelnuovo Abdu Musubire Agnes Kiragga Mohammed Lamorde Rosalind Parkes- Ratanshi |
| author_sort | Eva Agnes Odongpiny Laker |
| collection | DOAJ |
| description | Abstract Background The World Health Organisation approved boosted atazanavir as a preferred second line protease inhibitor in 2010. This is as an alternative to the current boosted lopinavir. Atazanavir has a lower genetic barrier than lopinavir. We compared the virological outcomes of patients during the roll out of routine viral load monitoring, who had switched to boosted second- line regimens of either atazanavir or lopinavir. Methods This was a cross-sectional study involving adult patients at the Infectious Diseases Institute Kampala, Uganda started on a standard WHO recommended second-line regimen containing either boosted atazanavir or boosted lopinavir between 1 Dec 2014 and 31 July 2015.. Mantel -Haenszel chi square was used to test for the statistical significance of the odds of being suppressed (VL < 400 copies/ml) when on boosted atazanavir compared to boosted lopinavir after stratifying by duration on antiretroviral therapy (ART). Multivariate logistic regression analysis used to determine if the type of boosted protease inhibitor (bPI) was associated with virological outcome. Results Ninety (90) % on ATV/r and 83% on LPV/r had a VL less than 1000 copies/ml. The odds of being suppressed using the same viral load cut-off while on boosted atazanavir compared to boosted lopinavir was not statistically significant after stratifying for duration on ART (p = 0.09). In a multivariate analysis the type of bPI used was not a predictor of virological outcome (p = 0.60). Conclusions Patients using the WHO recommended second-line of boosted atazanavir have comparable virological suppression to those on boosted lopinavir. |
| first_indexed | 2024-12-14T12:51:41Z |
| format | Article |
| id | doaj.art-dcaaa6a3a3f74cbaa060195c82778051 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-14T12:51:41Z |
| publishDate | 2019-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-dcaaa6a3a3f74cbaa060195c827780512022-12-21T23:00:40ZengBMCBMC Infectious Diseases1471-23342019-03-011911710.1186/s12879-019-3907-5An observational study in an urban Ugandan clinic comparing virological outcomes of patients switched from first-line antiretroviral regimens to second-line regimens containing ritonavir-boosted atazanavir or ritonavir-boosted lopinavirEva Agnes Odongpiny Laker0Maria Sarah Nabaggala1Arvind Kaimal2Damalie Nalwanga3Barbara Castelnuovo4Abdu Musubire5Agnes Kiragga6Mohammed Lamorde7Rosalind Parkes- Ratanshi8Infectious Diseases Institute, Makerere University College of Health SciencesInfectious Diseases Institute, Makerere University College of Health SciencesInfectious Diseases Institute, Makerere University College of Health SciencesInfectious Diseases Institute, Makerere University College of Health SciencesInfectious Diseases Institute, Makerere University College of Health SciencesInfectious Diseases Institute, Makerere University College of Health SciencesInfectious Diseases Institute, Makerere University College of Health SciencesInfectious Diseases Institute, Makerere University College of Health SciencesInfectious Diseases Institute, Makerere University College of Health SciencesAbstract Background The World Health Organisation approved boosted atazanavir as a preferred second line protease inhibitor in 2010. This is as an alternative to the current boosted lopinavir. Atazanavir has a lower genetic barrier than lopinavir. We compared the virological outcomes of patients during the roll out of routine viral load monitoring, who had switched to boosted second- line regimens of either atazanavir or lopinavir. Methods This was a cross-sectional study involving adult patients at the Infectious Diseases Institute Kampala, Uganda started on a standard WHO recommended second-line regimen containing either boosted atazanavir or boosted lopinavir between 1 Dec 2014 and 31 July 2015.. Mantel -Haenszel chi square was used to test for the statistical significance of the odds of being suppressed (VL < 400 copies/ml) when on boosted atazanavir compared to boosted lopinavir after stratifying by duration on antiretroviral therapy (ART). Multivariate logistic regression analysis used to determine if the type of boosted protease inhibitor (bPI) was associated with virological outcome. Results Ninety (90) % on ATV/r and 83% on LPV/r had a VL less than 1000 copies/ml. The odds of being suppressed using the same viral load cut-off while on boosted atazanavir compared to boosted lopinavir was not statistically significant after stratifying for duration on ART (p = 0.09). In a multivariate analysis the type of bPI used was not a predictor of virological outcome (p = 0.60). Conclusions Patients using the WHO recommended second-line of boosted atazanavir have comparable virological suppression to those on boosted lopinavir.http://link.springer.com/article/10.1186/s12879-019-3907-5Second-line antiretroviralFirst-line failureAtazanavirLopinavir |
| spellingShingle | Eva Agnes Odongpiny Laker Maria Sarah Nabaggala Arvind Kaimal Damalie Nalwanga Barbara Castelnuovo Abdu Musubire Agnes Kiragga Mohammed Lamorde Rosalind Parkes- Ratanshi An observational study in an urban Ugandan clinic comparing virological outcomes of patients switched from first-line antiretroviral regimens to second-line regimens containing ritonavir-boosted atazanavir or ritonavir-boosted lopinavir BMC Infectious Diseases Second-line antiretroviral First-line failure Atazanavir Lopinavir |
| title | An observational study in an urban Ugandan clinic comparing virological outcomes of patients switched from first-line antiretroviral regimens to second-line regimens containing ritonavir-boosted atazanavir or ritonavir-boosted lopinavir |
| title_full | An observational study in an urban Ugandan clinic comparing virological outcomes of patients switched from first-line antiretroviral regimens to second-line regimens containing ritonavir-boosted atazanavir or ritonavir-boosted lopinavir |
| title_fullStr | An observational study in an urban Ugandan clinic comparing virological outcomes of patients switched from first-line antiretroviral regimens to second-line regimens containing ritonavir-boosted atazanavir or ritonavir-boosted lopinavir |
| title_full_unstemmed | An observational study in an urban Ugandan clinic comparing virological outcomes of patients switched from first-line antiretroviral regimens to second-line regimens containing ritonavir-boosted atazanavir or ritonavir-boosted lopinavir |
| title_short | An observational study in an urban Ugandan clinic comparing virological outcomes of patients switched from first-line antiretroviral regimens to second-line regimens containing ritonavir-boosted atazanavir or ritonavir-boosted lopinavir |
| title_sort | observational study in an urban ugandan clinic comparing virological outcomes of patients switched from first line antiretroviral regimens to second line regimens containing ritonavir boosted atazanavir or ritonavir boosted lopinavir |
| topic | Second-line antiretroviral First-line failure Atazanavir Lopinavir |
| url | http://link.springer.com/article/10.1186/s12879-019-3907-5 |
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