Assessing the Efficacy of Lopinavir/Ritonavir-Based Preferred and Alternative Second-Line Regimens in HIV-Infected Patients: A Meta-Analysis of Key Evidence to Support WHO Recommendations

Frontiers in Pharmacology
Yinqiu HuangHao Wu

Abstract

Background: Nucleoside reverse transcriptase inhibitors (NRTIs) and non-NRTIs (NNRTIs) with boosted protease inhibitors are included in standardized first-line and second-line regimens. Recent World Health Organization (WHO) guidelines recommend a boosted protease inhibitor (PI) combined with 2 NRTIs or raltegravir as a second-line regimen. Objective: Ritonavir-boosted lopinavir (LPV/r) is known as a key second-line antiretroviral therapy (ART) in resource-limited settings. We carried out a meta-analysis to analyze virologic suppression and effectiveness of LPV/r-based second-line therapy in HIV-infected patients. Methods: In this meta-analysis, we searched randomized controlled trials and observational cohort studies to evaluate outcomes of second-line ART for patients with HIV who failed first-line therapy. A systematic search was conducted in Pubmed, Cochrane Library, and Embase from inception to January 2018. Outcomes included viral suppression, CD4 cell counts, drug resistance, adverse events, and self-reported adherence. We assessed comparative efficacy and safety in a meta-analysis. Data analysis was performed using RevMan 5.3 and Stata12.0. Results: Nine studies comprising 3,923 patients were included in the meta-analys...Continue Reading

References

Apr 21, 2005·BMC Medical Research Methodology·Stela Pudar HozoIztok Hozo
Oct 22, 2005·Current Medical Research and Opinion·C CohenUNKNOWN BMS AI424-043 Study Group
Dec 14, 2005·Statistics in Medicine·Roger M HarbordJonathan A C Sterne
Oct 26, 2006·Medical Care·Bruce R SchackmanKenneth A Freedberg
Apr 26, 2008·BMJ : British Medical Journal·Gordon H GuyattUNKNOWN GRADE Working Group
Oct 20, 2009·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Matthew P FoxIan Sanne
Feb 23, 2010·International Journal of Surgery·David MoherUNKNOWN PRISMA Group
Jun 18, 2010·The Cochrane Database of Systematic Reviews·Eliza H HumphreysJamal Harris
Mar 29, 2011·Journal of the International AIDS Society·Ellen 't HoenSuerie Moon
Aug 2, 2011·The Lancet Infectious Diseases·Raph L HamersUNKNOWN PharmAccess African Studies to Evaluate Resistance (PASER)
Oct 20, 2011·BMJ : British Medical Journal·Julian P T HigginsUNKNOWN Cochrane Statistical Methods Group
Jul 12, 2014·The New England Journal of Medicine·Nicholas I PatonUNKNOWN EARNEST Trial Team
Nov 8, 2017·The Lancet Infectious Diseases·James G HakimUNKNOWN Europe Africa Research Network for Evaluation of Second-line Therapy (EARNEST) Trial Team

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Software Mentioned

Cochrane
RevMan
Stata12
Excel

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