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BACKGROUND: Although efavirenz and lopinavir/ritonavir(r) are both recommended antiretroviral agents in antiretroviral-naive HIV-infected patients, there are few randomized comparisons of their efficacy and tolerability. METHODS: ...
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BACKGROUND: Although efavirenz and lopinavir/ritonavir(r) are both recommended antiretroviral agents in antiretroviral-naive HIV-infected patients, there are few randomized comparisons of their efficacy and tolerability. METHODS: A multicenter and randomized study was performed including 126 antiretroviral-naive patients, randomly assigned to efavirenz+Kivexa (n=63) or lopinavir/r+Kivexa (n=63). Efficacy endpoints were the percentage of patients with HIV-RNA < or =50 copies/mL at week 48 and CD4 recovery. Safety was assessed by comparing toxicity and discontinuations. Statistical analyses were performed on an intention-to-treat (ITT) basis (Missing=Failure). RESULTS: At week 48, 56.7% of patients in the efavirenz and 63.2% in the lopinavir/r groups showed HIV-1 RNA <50 copies/mL (P=0.770) (intention-to-treat analysis; Missing=Failure). Only 1 (1.53%) patient from each group experienced virological failure. CD4 values increased in both groups (298 cells in the efavirenz group, P=0.001; 249 cells in the lopinavir/r group, P=0.002; P=0.126 between groups). HDL-cholesterol only increased in the efavirenz group (from 39+/-12 mg/dL to 49+/-11; P=0.001). Discontinuations were more frequent in the lopinavir/r group (36.5% versus 28.5%; P=0.193), but more patients with efavirenz interrupted due to toxicity (11.1% versus 6.3%); most of them were attributed to hypersensitivity reaction. CONCLUSIONS: Similar virological efficacy was observed for efavirenz and lopinavir/r, when administered with Kivexa in antiretroviral-naive patients, while immunological improvement was slightly superior for efavirenz. The higher rate of discontinuation due to toxicity in the efavirenz group was related to a higher incidence of hypersensitivity reaction. Nowadays, the use of the new formulation of lopinavir/r and the HLA-B*5701 genotype test before starting abacavir should improve the safety profiles of these regimens.
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摘要 :
There is some experimental evidence that the pallial areas of a fish's brain are involved in distincted learning functions. Recently published data suggest that the medial pallium is essential for avoidance learning and the latera...
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There is some experimental evidence that the pallial areas of a fish's brain are involved in distincted learning functions. Recently published data suggest that the medial pallium is essential for avoidance learning and the lateral pallium is crucial for spatial learning and is also involved in temporal aspects of the learning processes. This data joined to the proposal of homologies between medial and lateral fish pallia and pallial amygdala and hippocampus respectively, suggest that the pallial areas could have preserved their functions throughout vertebrates' evolution. However, the functional implication of dorsal pallium that has been proposed as homologous to mammalian isocortex and transition cortex is largely unknown. In this study we analyze the role of dorsal pallium in trace and non-trace avoidance learning. Our results show the implication of this area in trace conditioning, but not in non-trace conditioning. This result allows discussion of homology proposals among lateral, dorsal, and medial pallia and hippocampus, isocortex, and pallial amygdala respectively.
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