Titre du document / Document title

Zidovudine and stavudine sequencing in HIV treatment planning: Findings from the CHORUS HIV Cohort

Auteur(s) / Author(s)

CHORUS Program Team, ETATS-UNIS
BECKER Stephen L. ⁽¹⁾ ; RAFFANTI Stephen R. ⁽²⁾ ; HANSEN Nellie I. ⁽³⁾ ; FUSCO Jennifer S. ⁽⁴⁾ ; FUSCO Gregory P. ⁽⁴⁾ ; SLATKO Gary H. ⁽⁴⁾ ; IGBOKO Ebere F. ⁽⁴⁾ ; GRAHAM Neil M. H. ⁽⁴⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Pacific Horizon Medical Group, San Francisco, California, ETATS-UNIS
⁽²⁾ Comprehensive Care Center, Nashville, Tennessee, ETATS-UNIS
⁽³⁾ Research Triangle Institute, Research Triangle Park, North Carolina, ETATS-UNIS
⁽⁴⁾ Glaxo Wellcome Inc., Research Triangle Park, North Carolina, ETATS-UNIS

Résumé / Abstract

Background: Optimal sequencing of zidovudine and stavudine in antiretroviral therapy has not been elucidated. Objective: To examine the impact of the sequence of therapeutic regimens containing zidovudine and stavudine on HIV-1 RNA and CD4 lymphocyte counts over 12 months. Design: Observational, multicenter, longitudinal cohort study. Setting: Four large outpatient, HIV practices participating in the community-based Collaborations in HIV Outcomes Research-U.S. (CHORUS) cohort study. Participants: 940 HIV-infected patients. Methods: Comparison of HIV-1 RNA and CD4 lymphocyte responses in patients sequenced from zidovudine to stavudine or from stavudine to zidovudine using repeated measures regression models fit to outcomes by application of generalized estimating equation (GEE) methodology. Results: Patients treated with zidovudine prior to stavudine (n = 834) achieved a greater mean drop from baseline HIV-I RNA (p = .01) and higher proportion of undetectable HIV-1 RNA results (p = .05) over 12 months than those sequenced from stavudine to zidovudine (n = 106). CD4⁺ lymphocyte increases did not differ between the groups (p = .6). Conclusions: Prior zidovudine therapy was not associated with long-term attenuation of HIV-I RNA or CD4 response to subsequent stavudine-containing regimens. Zidovudine before stavudine may have benefit in a strategic long-term therapeutic plan.

Revue / Journal Title

Journal of acquired immune deficiency syndromes   ISSN 1525-4135 

Source / Source

2001, vol. 26, n^o1, pp. 72-81 (37 ref.)

Langue / Language

Anglais

Editeur / Publisher

Lippincott Williams & Wilkins, Hagerstown, MD, ETATS-UNIS  (1999) (Revue)

Mots-clés anglais / English Keywords

Enzyme ; Transferases ; Nucleotidyltransferases ; Immune deficiency ; Immunopathology ; Infection ; Viral disease ; Virus ; Retroviridae ; Lentivirus ; Enzyme inhibitor ; RNA-directed DNA polymerase ; Pyrimidine nucleoside ; Reverse transcriptase inhibitor ; Dideoxynucleoside ; Nucleosidic analog ; Stavudine ; Zidovudine ; Fitness ; Models ; AIDS ; Multicenter study ; Lymphocyte ; Antiviral ; Treatment ; Human ; HIV-1 virus ; Human immunodeficiency virus ;

Mots-clés français / French Keywords

Enzyme ; Transferases ; Nucleotidyltransferases ; Immunodéficit ; Immunopathologie ; Infection ; Virose ; Virus ; Retroviridae ; Lentivirus ; Antigène CD4 ; Inhibiteur enzyme ; RNA-directed DNA polymerase ; Pyrimidine nucléoside ; Inhibiteur reverse transcriptase ; Didésoxynucléoside ; Analogue nucléoside ; Stavudine ; Zidovudine ; Fitness ; Modèle ; SIDA ; Etude multicentrique ; Lymphocyte ; Antiviral ; Traitement ; Homme ; Virus HIV1 ; Virus immunodéficience humaine ;

Mots-clés espagnols / Spanish Keywords

Enzima ; Transferases ; Nucleotidyltransferases ; Inmunodeficiencia ; Inmunopatología ; Infección ; Virosis ; Virus ; Retroviridae ; Lentivirus ; Inhibidor enzima ; RNA-directed DNA polymerase ; Pirimidina nucleósido ; Inhibitor reverse transcriptase ; Didesoxinucleósido ; Análogo nucleósido ; Estavudina ; Zidovudina ; Adecuación ; Modelo ; SIDA ; Estudio multicéntrico ; Linfocito ; Antiviral ; Tratamiento ; Hombre ; HIV-1 virus ; Human immunodeficiency virus ;

Localisation / Location

INIST-CNRS, Cote INIST : 21576, 35400009386450.0090