OBJECTIVES: Many @entity1 have simplified their therapy by replacing protease inhibitors (PI) with efavirenz. In a large cohort study representative of clinical practice, we compared outcomes in @entity1 who replaced PI with efavirenz (switchers), with @entity1 who continued on PI (non-switchers). We investigated the likelihood of virological failure in switchers and non-switchers, and the tolerance of efavirenz-containing regimens in different transmission risk groups. DESIGN, SETTING, AND METHODS: Using the database of the Swiss @entity645 Cohort Study, we identified @entity1 who switched from PI-containing to efavirenz-containing highly active antiretroviral therapy for reasons of tolerance, @entity137 , or convenience. Switchers were matched to non-switchers on the basis of calendar time, CD4 cell count, and viral load. RESULTS: The probability of virological failure was less in @entity1 who switched to efavirenz values after one year: 9.4% [95% confidence interval (CI) 5.5-15.9] versus 27.2% (95% CI 21.5-34.1), odds ratio (OR) for failure 0.34. The effect was more pronounced when injection drug users (IDU) were omitted from the analysis (OR 0.19, 95% CI 0.09-0.43); it was absent in IDU (OR 0.95, 95% CI 0.44-2.04). IDU stopped efavirenz more frequently during the first 2 months of treatment than non- @entity28299 [22.6% (95% CI 11.5-41.6) versus 6.6% (95% CI 3.6-11.8) at 2 months]. No difference between IDU and non-IDU was evident when the frequency of stopping @entity5190 or @entity5191 was measured. CONCLUSION: Switchers had less virological failure and less chance of further treatment changes than non-switchers. However, efavirenz was less successful in IDU than in other transmission categories.

Switching from protease inhibitors to efavirenz: differences in efficacy and tolerance among risk groups: a case-control study from the Swiss XXXX Cohort.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity5191 :: ('MESH:D019888', 'Chemical') :: ['nelfinavir'] @entity137 :: ('MESH:D064420', 'Disease') :: ['toxicity'] @entity5190 :: ('MESH:D019469', 'Chemical') :: ['indinavir'] @entity645 :: ('57667', 'Species') :: ['HIV'] @entity28299 :: ('CHEBI:147675', 'Chemical') :: ['IDU']
@entity645 :: (57667,Species) :: ['HIV']
