Nieuwkerk P, Reijers M, Lange J, Sprangers M; Conference on Retroviruses and Opportunistic Infections.
Program Abstr 6th Conf Retrovir Oppor Infect Conf Retrovir Oppor Infect 6th 1999 Chic Ill. 1999 Jan 31-Feb 4; 6th: 86 (abstract no. 100).
Academic Medical Center, Amsterdam, The Netherlands.
Maintenance dual therapy after 26 weeks quadruple induction therapy has shown to be inferior to prolonged induction regarding viral suppression(1). However, prolongation of the quadruple regimen may be hampered by a negative impact on QoL due to pill burden. We compared QoL in prolonged induction versus maintenance therapy. Design:Randomized trial in which pts with >200 CD4 cells/mm3 and >1000 HIV RNA copies/ml after 26 weeks of induction (d4T/3TC/SQV/NFV) were allocated maintenance (d4T/NFV or SQV/NFV) or prolonged induction. In a subsample, changes in QoL from week 24 to 48 were assessed by the MOS HIV Health Survey. Effect sizes for between group differences were calculated by dividing mean differences by pooled standard deviations. Analysis was by intention to treat. Results:9 out of 15 pts allocated prolonged induction, and 11 out of 16 pts allocated maintenance participated in the QoLstudy. Pts allocated maintenance showed more decline in QoL compared to pts allocated prolonged induction on the following subscales, with effect sizes (ES) being moderate to large: social- (-17 ES 0.5), physical- (-11 ES 0.4), and role-function (-18 ES 0.4), health distress (-17 ES 0.7), quality of life (-19 ES 0.7), health perceptions (-13 ES 0.5). Conclusion:QoL declined more in maintenance therapy compared to prolonged induction. Most likely, inferior viral suppression associated with maintenance therapy added to this more negative impact that outweighed burden of the prolonged quadruple regimen.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Antiretroviral Therapy, Highly Active
- Drug Therapy, Combination
- HIV Infections
- Lamivudine
- Stavudine
- drug therapy
- therapy
Other ID:
UI: 102188720
From Meeting Abstracts