@article {10868,
	title = {Boosted lopinavir- versus boosted atazanavir-containing regimens and immunologic, virologic, and clinical outcomes: a prospective study of HIV-infected individuals in high-income countries.},
	journal = {Clin Infect Dis},
	volume = {60},
	year = {2015},
	month = {2015 Apr 15},
	pages = {1262-8},
	abstract = {BACKGROUND: Current clinical guidelines consider regimens consisting of either ritonavir-boosted atazanavir or ritonavir-boosted lopinavir and a nucleoside reverse transcriptase inhibitor (NRTI) backbone among their recommended and alternative first-line antiretroviral regimens. However, these guidelines are based on limited evidence from randomized clinical trials and clinical experience.

METHODS: We compared these regimens with respect to clinical, immunologic, and virologic outcomes using data from prospective studies of human immunodeficiency virus (HIV)-infected individuals in Europe and the United States in the HIV-CAUSAL Collaboration, 2004-2013. Antiretroviral therapy-naive and AIDS-free individuals were followed from the time they started a lopinavir or an atazanavir regimen. We estimated the {\textquoteright}intention-to-treat{\textquoteright} effect for atazanavir vs lopinavir regimens on each of the outcomes.

RESULTS: A total of 6668 individuals started a lopinavir regimen (213 deaths, 457 AIDS-defining illnesses or deaths), and 4301 individuals started an atazanavir regimen (83 deaths, 157 AIDS-defining illnesses or deaths). The adjusted intention-to-treat hazard ratios for atazanavir vs lopinavir regimens were 0.70 (95\% confidence interval [CI], .53-.91) for death, 0.67 (95\% CI, .55-.82) for AIDS-defining illness or death, and 0.91 (95\% CI, .84-.99) for virologic failure at 12 months. The mean 12-month increase in CD4 count was 8.15 (95\% CI, -.13 to 16.43) cells/{\textmu}L higher in the atazanavir group. Estimates differed by NRTI backbone.

CONCLUSIONS: Our estimates are consistent with a lower mortality, a lower incidence of AIDS-defining illness, a greater 12-month increase in CD4 cell count, and a smaller risk of virologic failure at 12 months for atazanavir compared with lopinavir regimens.},
	keywords = {Adolescent, Adult, Anti-HIV Agents, Antiretroviral Therapy, Highly Active, Atazanavir Sulfate, CD4 Lymphocyte Count, Cohort Studies, Cooperative Behavior, Developed Countries, Europe, Female, HIV Infections, Humans, Lopinavir, Male, Middle Aged, Prospective Studies, Treatment Outcome, United States, Viral Load, Young Adult},
	issn = {1537-6591},
	doi = {10.1093/cid/ciu1167},
	author = {Cain, Lauren E and Phillips, Andrew and Olson, Ashley and Sabin, Caroline and Jose, Sophie and Justice, Amy and Tate, Janet and Logan, Roger and Robins, James M and Sterne, Jonathan A C and van Sighem, Ard and Reiss, Peter and Young, James and Fehr, Jan and Touloumi, Giota and Paparizos, Vasilis and Esteve, Anna and Casabona, Jordi and Monge, Susana and Moreno, Santiago and Seng, R{\'e}monie and Meyer, Laurence and P{\'e}rez-Hoyos, Santiago and Muga, Roberto and Dabis, Fran{\c c}ois and Vandenhende, Marie-Anne and Abgrall, Sophie and Costagliola, Dominique and Hern{\'a}n, Miguel A}
}
