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Nucleoside analogue use before and during highly active antiretroviral therapy and virus load rebound.

Collaboration of HIV Cohorts, ; (2004) Nucleoside analogue use before and during highly active antiretroviral therapy and virus load rebound. J Infect Dis , 190 (4) pp. 675-687. 10.1086/421707.

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Abstract

Patients who use nucleoside reverse-transcriptase inhibitors (NRTIs) before highly active antiretroviral therapy (HAART) have an increased rate of virus rebound. Study of rebound according to specific NRTIs used might inform which NRTIs retain activity once others have failed. We focused on 2280 patients who had received zidovudine and either didanosine or lamivudine before starting HAART, started HAART that included zidovudine with didanosine or lamivudine or stavudine with didanosine or lamivudine, and had virus loads <500 copies/mL within 24 weeks. In a Cox model, the relative hazard (RH) of virus rebound for having switched from zidovudine to stavudine (vs. retaining zidovudine) was 0.94 (95% confidence interval [CI], 0.77-1.15), which suggests little or no benefit in terms of reduced rebound rate. Having switched from didanosine to lamivudine, or vice versa, was associated with a reduced rebound rate (RH, 0.59 [95% CI, 0.48-0.73]), which suggests that these drugs retain appreciable activity after use of the other and of zidovudine.

Type: Article
Title: Nucleoside analogue use before and during highly active antiretroviral therapy and virus load rebound.
Location: United States
DOI: 10.1086/421707
Keywords: Adult, Anti-HIV Agents, Antiretroviral Therapy, Highly Active, Australia, Cohort Studies, Didanosine, Drug Administration Schedule, Europe, Female, HIV Infections, Humans, Lamivudine, Male, Proportional Hazards Models, Reverse Transcriptase Inhibitors, Stavudine, Time Factors, Viral Load, Zidovudine
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Respiratory Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Inst of Clinical Trials and Methodology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute for Global Health > Infection and Population Health
URI: http://discovery.ucl.ac.uk/id/eprint/161955
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