PMID- 21126959
OWN - NLM
STAT- MEDLINE
DCOM- 20110106
LR  - 20101203
IS  - 1528-4336 (Print)
IS  - 1528-4336 (Linking)
VI  - 11
IP  - 5
DP  - 2010 Sep-Oct
TI  - Comparison of antiviral activity of regimens containing nucleos(t)ide (NUC) Pairs 
      in HIV-Infected Patients Initiating REScue therapy (The NUCREST Study).
PG  - 294-302
LID - 10.1310/hct1105-294 [doi]
AB  - BACKGROUND: recycling nucleos(t)ides (NUCs) is useful in regions where new 
      antiretrovirals are not available. This study compares the effectiveness of 
      NUC-containing regimens as rescue therapy in routine care. METHODS: 
      retrospective, multicentre cohort study (January 2001 to June 2006) of patients 
      with >/= 1 virological failure who started therapy with 2 NUCs and 1 non-nucleoside 
      reverse transcriptase inhibitor (NNRTI) or a protease inhibitor (PI). The primary 
      endpoint was the rate of treatment response at 6 months (intention-to-treat [ITT] 
      analysis). RESULTS: we included 719 patients (average of 4 prior regimens over a 
      median 6.1 years). The most frequent NUC pairs were tenofovir plus lamivudine 
      (TDF+3TC; 25%), tenofovir plus stavudine (TDF+d4T; 23%), and stavudine plus 
      didanosine (d4T+ddI; 15%). A boosted PI was used in 68% of total cases. 
      Resistance to both NUCs was more frequent in zidovudine plus lamivudine (AZT+3TC; 
      22.0%), abacavir plus lamivudine (ABC+3TC; 35.5%), and stavudine plus lamivudine 
      (d4T+3TC; 31.2%). No significant differences were observed in treatment response 
      (overall 65%, P = .67); ddI+3TC (71%) and d4T+3TC (53%) had the highest and 
      lowest response rates, respectively. Median time to failure was shorter with 
      d4T+3TC, d4T+ddI, and ABC+3TC (48, 51, and 58 weeks, respectively; P = .0012). 
      Lower response rates associated with an increasing number of thymidine analog 
      mutations (TAMs) were observed for ABC+3TC (P = .027). CONCLUSION: the clinical 
      utility of NUCs for rescue therapy is limited and selection should be 
      individualized. Specific combinations (d4T+3TC and d4T+ddI) might be less 
      efficacious.
FAU - Perez-Molina, J A
AU  - Perez-Molina JA
AD  - Infectious Diseases, Hospital Ramon y Cajal, Madrid, Spain. 
      jose.perezmolina@gmail.com
FAU - Serrano, O
AU  - Serrano O
FAU - Milinkovic, A
AU  - Milinkovic A
FAU - Domingo, P
AU  - Domingo P
FAU - Curran, A
AU  - Curran A
FAU - Knobel, H
AU  - Knobel H
FAU - Gaspar, G
AU  - Gaspar G
FAU - Rodrigo, A
AU  - Rodrigo A
FAU - Jimenez-Exposito, M J
AU  - Jimenez-Exposito MJ
FAU - Hernandez-Novoa, B
AU  - Hernandez-Novoa B
FAU - Moreno, S
AU  - Moreno S
FAU - The NUCREST Study
AU  - The NUCREST Study
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - HIV Clin Trials
JT  - HIV clinical trials
JID - 100936377
RN  - 0 (RNA, Viral)
RN  - 0 (Reverse Transcriptase Inhibitors)
SB  - IM
MH  - Adult
MH  - Cohort Studies
MH  - Female
MH  - *HIV
MH  - HIV Infections/blood/*drug therapy/immunology/virology
MH  - Humans
MH  - Male
MH  - RNA, Viral/blood
MH  - Retrospective Studies
MH  - Reverse Transcriptase Inhibitors/*administration & dosage
EDAT- 2010/12/04 06:00
MHDA- 2011/01/07 06:00
CRDT- 2010/12/04 06:00
PHST- 2010/12/04 06:00 [entrez]
PHST- 2010/12/04 06:00 [pubmed]
PHST- 2011/01/07 06:00 [medline]
AID - 034N7785726153G3 [pii]
AID - 10.1310/hct1105-294 [doi]
PST - ppublish
SO  - HIV Clin Trials. 2010 Sep-Oct;11(5):294-302. doi: 10.1310/hct1105-294.