aCenter for Biostatistics in AIDS Research, Harvard School of Public Health, Boston, Massachusetts bFred Hutchinson Cancer Research Center, Seattle, Washington cUniversity of Washington, Seattle, Washington dNorthwestern University Feinberg School of Medicine, Division of Infectious Diseases, Chicago, Illinois eBirmingham Veterans Affairs Medical Center and University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA.
AIDS. 2013 Jul 31;27(12):1887-97. doi: 10.1097/QAD.0b013e328361645f.
Efavirenz (EFV) along with two nucleoside reverse transcriptase inhibitors (NRTIs) is a recommended initial antiretroviral regimen. Understanding characteristics related to EFV success is clinically useful.
Data from 2220 antiretroviral-naive participants randomized to EFV and two to three NRTIs in four ACTG trials as well as a long-term cohort were analysed.
Logistic regression, using inverse probability of censoring weighting to address selective-follow-up bias, was used to identify factors associated with EFV success (no treatment interruptions of >30 days, HIV RNA < 200 copies/ml) 1 year post initiation and at years 2-5 if successful at year 1.
Pretreatment characteristics were median age 38 years, 82% male, 40% white, 10% history of IDU (HxIDU), median CD4+ T-lymphocyte 227 cells/μl and 33% HIV RNA more than 100 ,000 copies/ml. In a multivariable model, factors associated with year 1 EFV success were race [white odds ratio (OR) 1.5; P < 0.001; Hispanic OR 1.5; P = 0.003 vs. black], no pretreatment sign/symptom grade 3 or higher (OR 1.7; P = 0.008) and no HxIDU (OR 1.7; P = 0.001). Predictors of EFV success at years 2-5 were no HxIDU (years 2-5; ORs 1.9-2.2); self-reported complete (4 days prior to study visit) adherence during year 1 (years 2-4; ORs 1.6-1.9); fewer missed visits during year 1 (years 2, 4, 5; ORs 0.92-0.98/1% increase); HIV RNA less than 50 copies/ml at year 1 (years 2, 3; ORs 1.9-2.2); and older age (>50 vs. ≤30 years) (years 2-4: ORs 2.3-3.7).
Characteristics predictive of EFV success in the short-term and longer term differed except for HxIDU. Behaviours occurring during year 1 were associated with EFV success over 5 years.
依非韦伦（EFV）联合两种核苷类逆转录酶抑制剂（NRTIs）是推荐的初始抗逆转录病毒治疗方案。了解与 EFV 成功相关的特征在临床上是有用的。
对来自四个 ACTG 试验的 2220 名接受 EFV 和两种至三种 NRTIs 治疗的初治参与者的数据以及一个长期队列进行了分析。
使用逆概率 censoring 加权来解决选择性随访偏倚的逻辑回归，用于确定与 EFV 成功（无 30 天以上的治疗中断，HIV RNA < 200 拷贝/ml）相关的因素，以及在第 1 年成功的情况下在第 2-5 年的因素。
治疗前特征为中位年龄 38 岁，82%为男性，40%为白人，10%有静脉吸毒史（HxIDU），中位 CD4+T 淋巴细胞 227 个/μl，33%HIV RNA 超过 100,000 拷贝/ml。在多变量模型中，与第 1 年 EFV 成功相关的因素包括种族[白人比值比（OR）1.5；P<0.001；西班牙裔 OR 1.5；P=0.003 比黑人]、无预处理症状/体征 3 级或更高（OR 1.7；P=0.008）和无 HxIDU（OR 1.7；P=0.001）。第 2-5 年 EFV 成功的预测因素包括无 HxIDU（第 2-5 年；ORs 1.9-2.2）；第 1 年报告的完全（在研究就诊前 4 天）依从性（第 2-4 年；ORs 1.6-1.9）；第 1 年错过的就诊次数减少（第 2、4、5 年；ORs 0.92-0.98/1%增加）；第 1 年 HIV RNA 小于 50 拷贝/ml（第 2、3 年；ORs 1.9-2.2）；以及年龄较大（>50 岁比≤30 岁）（第 2-4 年：ORs 2.3-3.7）。
短期和长期 EFV 成功的预测特征不同，除了 HxIDU。第 1 年发生的行为与 5 年内的 EFV 成功相关。
