AEGiS-14IAC: Multivariate logistic regression analysis of factors predictive of the virological response in the Narval trial.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Multivariate logistic regression analysis of factors predictive of the virological response in the Narval trial.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. ThOrB1387)

Vray M, Meynard JL, Dalban C, Morand-Joubert L, Brun-Vezinet F, Clavel F, Costagliola D, Girard PM
Inserm SC4, Paris, France

OBJECTIVE: To identify factors predictive of W12 virological response.

METHODS: The NARVAL trial was conducted to assess the respective benefit of Phenotype (P),Genotype (G) versus standard of care (SOC) for the choice of antiretroviral therapy in patients failing a PI-containing regimen. Virological success was defined as viral load (VL) le 200 copies/ml at W12. Baseline variables including demographic, clinical and biological characteristics, drug resistance mutations, randomization arm, compliance to treatment and drugs prescribed were analyzed univariately. Significant variables were included in a logistic regression model.

RESULTS: 541 patients were randomized. Median baseline CD4 counts and VL were 339 cells/mm³ and 3.4 log cp/ml, respectively. 202 patients reached virological success at W12. In multivariate analysis, the factors significantly associated with virological success were: prescription of EFV in NNRTI-naïve patients (OR=4.37; 95%CI, 2.76-6.90), randomization in G arm (OR=2.13, 1.20-3.80), prescription of 3TC (OR=1.69, 1.01-2.83) and prescription of abacavir (ABC) in ABC-naïve patients (OR=1.66, 1.02-2.72). Factors significantly associated with virological failure were: prescription of NFV (OR=0.30, 0.13-0.68), baseline VL (OR=0.37, 0.28-0.50), presence of ge 5 PI mutations (OR=0.42, 0.26-0.66), presence of ge 3 NAMs (OR=0.61, 0.39-0.97), previous PI exposure ge 30 months (OR=0.64, 0.41-0.99).

CONCLUSIONS: Randomization in G group, prescription of EFV, ABC or 3TC were associated with an increased virological success rate. In contrast, a high number of resistance mutations, long prior exposure to PIs, high baseline VL and prescription of NFV were associated with a decreased virological success rate.

Keywords: AEGIS, Viral Load, CD4 Lymphocyte Count, Lamivudine, Dideoxynucleosides, Phenotype, Genotype, abacavir, Human, virology, genetics

020707
ThOrB1387