12th Annual Conference of the British HIV Association 29 March–1 April 2006, Brighton, UK

RESPONSE TO EFAVIRENZ (EFV)-CONTAINING REGIMENS IN PREVIOUSLY ANTIRETROVIRAL-NAÏVE PATIENTS: THE ROLE OF GENDER

HIV Med 2006 Mar 29-Apr 1 (Suppl 1);12:14 (abstract no. P15)

Colette Smith¹, Margaret Johnson², Mike Youle², Fiona Lampe¹, Caroline Sabin¹ and Andrew Phillips^1
1 Royal Free and University College Medical School, London, ² Royal Free Hospital, London, UK

OBJECTIVES: We investigated the role of gender in the response to efavirenz (EFV)-containing regimens.

METHODS: All previously antiretroviral-naïve individuals starting EFV from 1996 onwards in a single large clinical centre were included. Virological failure (VF) was defined as the first of two consecutive viral loads >400 copies/ml.

RESULTS: Of 81 women starting EFV, 61 (73%) were black African, 80 (95%) heterosexual and the median pre-ART CD4 count was 120 (IQR = 34, 215) cells/μl. 199/297 (66%) men starting EFV were white, 210 (70%) homosexual and the median pre-ART CD4 count was 181 (92, 261) cells/µl. 34% (95% CI: 24–45%) women had stopped EFV by 48 weeks compared to 26% men (21%, 31%; P=0.1). CNS effects was the reason given for stopping in 44% of men and 26% of women discontinuing EFV; 10% of men and 7% of women discontinuing did so due to treatment failure. After 48 and 96 weeks 4.1% (1.6–6.6%) and 6.4% (3.1–9.7%) of men and 2.9% (0.0–7.0%) and 4.6% (0.0–9.6%) of women respectively had experienced VF (ignore treatment changes, censor when discontinue all ART; HR = 1.26; 95% CI: 0.42–3.74; P=0.68). This became 27.5% (22.2–32.8%) and 43.1% (36.8–49.5%) for men and 34.7% (24.1–45.3%) and 49.0% (37.2–42.9%) for women when considering those discontinuing EFV as experiencing failure (HR = 0.77; 95% CI: 0.54–1.10; P=0.15). The median (IQR) change in CD4 count after 48 weeks was +165 (+85, +238) cells/µl in men and +183 (+111, +265) cells/µl in women (P=0.31).

CONCLUSION: We found no evidence for gender differences in virological and immunological response to efavirenz-based regimens. Larger studies are necessary to further explore these questions.

2006-03-29
P15

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