Pulido Ortega, FedericoRubio García, RafaelGatel, José M.2024-07-312024-07-312004-04-01Pulido F, Arribas JR, Miró JM, Costa MA, González J, Rubio R, Peña JM, Torralba M, Lonca M, Lorenzo A, Cepeda C, Vázquez JJ, Gatell JM; EfaVIP Cohort Study Group. Clinical, virologic, and immunologic response to efavirenz-or protease inhibitor-based highly active antiretroviral therapy in a cohort of antiretroviral-naive patients with advanced HIV infection (EfaVIP 2 study). J Acquir Immune Defic Syndr. 2004 Apr 1;35(4):343-501525-413510.1097/00126334-200404010-00003https://hdl.handle.net/20.500.14352/107282Objective: To compare the clinical, immunologic, and virologic outcomes of efavirenz (EFV)-based versus protease inhibitor (PI)-based highly active antiretroviral therapy (HAART) in severely immunosuppressed HIV-1-infected patients. Design: Retrospective observational cohort study. Methods: Responses were analyzed according to the intent-to-treat principle among antiretroviral-naive patients with < 100 CD4 cells/muL who started EFV (n = 92) or a PI (n = 218) plus 2 nucleoside reverse transcriptase inhibitors. The primary end point was time to treatment failure. Secondary end points were percentage of patients with a viral load < 400 copies/mL, time to virologic failure, time to CD4 lymphocyte count > 200 cells/microL, and incidence of opportunistic events or death. Results: The median baseline CD4 cell count and viral load were 34 cells/microL and 5.54 log10 copies/mL (EFV group) and 38 cells/microL and 5.40 log10 copies/mL (PI group). Time to treatment failure was shorter with a PI-based regimen than with an EFV-based regimen (adjusted relative hazard [RH] = 2.19, 95% confidence interval [CI]: 1.23-3.89). After 12 months of therapy, a significantly higher proportion of patients receiving EFV reached a viral load < 400 copies/mL (69.4 vs. 45.1%; P < 0.05). The probability of virologic failure was higher with a PI than with EFV (adjusted HR = 2.52, 95% CI: 1.14-5.61; P = 0.024). There was no difference in time to CD4 cell count > 200 cells/microL or in incidence of opportunistic events or death. Conclusion: : In severely immunosuppressed, antiretroviral-naive, HIV-1-infected patients, treatment with an EFV-based regimen compared with a nonboosted PI-based regimen resulted in a superior virologic response with no difference in immunologic or clinical effectiveness.engjournal article1077-9450https://doi.org/10.1097/00126334-200404010-00003https://journals.lww.com/jaids/abstract/2004/04010/clinical,_virologic,_and_immunologic_response_to.3.aspxrestricted access616.98VIHHIVefavirenzprotease inhibitorantiretroviral-naive patientsadvanced HIV infectionCiencias Biomédicas32 Ciencias Médicas