Journal of Antivirals & Antiretrovirals
Open Access

Abstract

Outcomes of Ritonavir-Boosted Protease Inhibitor Versus Non-Nucleoside Reverse Transcriptase Regimens in a Clinical Practice Cohort

Richard D Moore and Ritesh Kumar

The objectives of this longitudinal clinical outcomes study were to: (1) compare rates and types of adverse events (AEs), adherence scores, and quality-of-life (QoL) scores in patients using ritonavir-boosted protease inhibitor (PI) regimens versus nonnucleoside reverse transcriptase inhibitor (NNRTI) regimens; and (2) determine the relationship between speed of initial HIV-1 RNA reduction after initiating highly active antiretroviral therapy and time to resistance development (or treatment failure). A total of 198 ritonavirboosted PI- and 271 NNRTI-initiating patients were evaluated. The time to achieve suppressed HIV-1 RNA (<50 copies/ mL) ranged from 4.5 to 6 months. Although the time to discontinuation of initial therapy between the groups was similar, a shorter time to viral suppression was associated with a longer duration of effective therapy. Approximately 75% of patients achieving undetectable HIV-1 RNA maintained suppressed HIV-1 RNA over a 2-year follow-up period, although those patients receiving an NNRTI-based regimen were more likely to maintain suppressed HIV-1 RNA than those receiving a PI-based regimen (log-rank test; p=0.05). No significant differences in AEs, adherence, or QoL were reported. As newer classes of drugs become increasingly used in clinical practice, it will be important to determine whether improved outcomes will result.