The use of dual therapy with the CCR5-receptor antagonist MVC in combination with a PI/r has been assessed in one RCT but was not designed to show non-inferiority [47]. The comparative efficacy of the INI RAL plus a PI/r is being compared with standard triple therapy in several ongoing and/or unpublished studies [48-52]. Reports from one study [48, 49] suggest similar rates of virological suppression at

48 and 96 weeks. However, in a single-arm study investigating RAL in combination with DRV/r, a significantly increased risk of virological failure with emergent INI resistance was seen in patients with baseline VL >100 000 copies/mL compared with those with a baseline VL < 100 000 copies/mL [53]. Further data are required and there is a need to await the results of ongoing randomized trials. "
“The long-term outcome of antiretroviral therapy (ART) is not assessed in controlled trials. PLX4032 order We aimed to analyse trends in the population effectiveness of ART in the Swiss HIV Cohort Study over the last decade. We analysed the odds of stably suppressed viral load (ssVL: three consecutive values <50 HIV-1 RNA copies/mL) and of CD4 cell count exceeding

500 cells/μL for each year between 2000 and 2008 in three scenarios: an open cohort; a closed cohort ignoring the influx of new participants after 2000; and a worst-case closed cohort retaining lost or dead patients ADP ribosylation factor as virological failures in subsequent years. We used generalized estimating equations with sex, age, risk, non-White ethnicity and era of starting combination ART (cART) as fixed co-factors. GDC-0449 cost Time-updated co-factors included type of ART regimen, number of new drugs and adherence to therapy. The open cohort included 9802

individuals (median age 38 years; 31% female). From 2000 to 2008, the proportion of participants with ssVL increased from 37 to 64% [adjusted odds ratio (OR) per year 1.16 (95% CI 1.15–1.17)] and the proportion with CD4 count >500 cells/μL increased from 40 to >50% [OR 1.07 (95% CI 1.06–1.07)]. Similar trends were seen in the two closed cohorts. Adjustment did not substantially affect time trends. There was no relevant dilution effect through new participants entering the open clinical cohort, and the increase in virological/immunological success over time was not an artefact of the study design of open cohorts. This can partly be explained by new treatment options and other improvements in medical care. Combination antiretroviral therapy (cART) has dramatically reduced morbidity and mortality in HIV-infected persons with access to care [1–3]. Since 1996, the number of anti-HIV drugs in different classes has increased, providing numerous potent and well-tolerated regimens to choose from, especially in resource-rich countries.