2026-04-13T01:55:12Zhttps://recercat.cat/oai/request

oai:recercat.cat:2072/4677822025-10-13T10:21:35Zcom_2072_98col_2072_378192

00925njm 22002777a 4500 dc Cain, Lauren E. author Caniglia, Ellen C. author Phillips, Andrew author Olson, Ashley author Muga, Roberto author Pérez Hoyos, Santiago author Abgrall, Sophie author Costagliola, Dominique author Rubio, Rafael author Jarrín, Inma author Bucher, Heiner author Fehr, Jan author van Sighem, Ard author Reiss, Peter author Dabis, François author Vandenhende, Marie-Anne author Logan, Roger author Robins, James author Sterne, Jonathan A C author Justice, Amy C author Tate, Janet author Touloumi, Giota author Paparizos, Vasilis author Esteve, Anna author Casabona-Barbarà, Jordi author Seng, Rémonie author Meyer, Laurence author Jose, Sophie author Sabin, Caroline A author Hernán, Miguel A author HIV CAUSAL Collaboration author Universitat Autònoma de Barcelona. Departament de Medicina author 2016 Altres ajuts: NIH R01-AI073127, U10-AA013566; MRC G0700820 Objective: To compare regimens consisting of either ritonavir-boosted atazanavir or efavirenz and a nucleoside reverse transcriptase inhibitor (NRTI) backbone with respect to clinical, immunologic, and virologic outcomes. Design: Prospective studies of human immunodeficiency virus (HIV)-infected individuals in Europe and the United States included in the HIV-CAUSAL Collaboration. Methods: HIV-positive, antiretroviral therapy-naive, and acquired immune deficiency syndrome (AIDS)-free individuals were followed from the time they started an atazanavir or efavirenz regimen. We estimated an analog of the "intention-to-treat" effect for efavirenz versus atazanavir regimens on clinical, immunologic, and virologic outcomes with adjustment via inverse probability weighting for time-varying covariates. Results: A total of 4301 individuals started an atazanavir regimen (83 deaths, 157 AIDS-defining illnesses or deaths) and 18,786 individuals started an efavirenz regimen (389 deaths, 825 AIDS-defining illnesses or deaths). During a median follow-up of 31 months, the hazard ratios (95% confidence intervals) were 0.98 (0.77, 1.24) for death and 1.09 (0.91, 1.30) for AIDS-defining illness or death comparing efavirenz with atazanavir regimens. The 5-year survival difference was 0.1% (95% confidence interval: -0.7%, 0.8%) and the AIDS-free survival difference was -0.3% (-1.2%, 0.6%). After 12 months, the mean change in CD4 cell count was 20.8 (95% confidence interval: 13.9, 27.8) cells/mm3 lower and the risk of virologic failure was 20% (14%, 26%) lower in the efavirenz regimens. Conclusion: Our estimates are consistent with a smaller 12-month increase in CD4 cell count, and a smaller risk of virologic failure at 12 months for efavirenz compared with atazanavir regimens. No overall differences could be detected with respect to 5-year survival or AIDS-free survival. Atazanavir Efavirenz HIV Mortality Observational studies SDG 3 - Good Health and Well-being Efavirenz versus boosted atazanavir-containing regimens and immunologic, virologic, and clinical outcomes : A prospective study of HIV-positive individuals