To assess the life-time costs and effects of a TPV/r based regimen compared to CPI/r, we used two theoretical groups of 1000 HIV-1 infected patients in the Netherlands.
The relative risk of cardiovascular events was 0.91 (95% confidence interval 0.81 to 1.02) in trials where controls had no exposure to folic acid based regimens, compared with 0.99 (0.93 to 1.06) in trials where controls did have some level of exposure, either through fortification or through comparator treatment.
Overall, 21 major cardiovascular events were prevented for every 1000 participants treated (ACE inhibitor or calcium channel blocker based regimens) compared with placebo (number needed to treat (NNT) for preventing one event over an average of four years was 47).
A 5 mm Hg reduction in systolic blood pressure had almost identical effects on major cardiovascular events at different eGFR, with no difference between ACE inhibitor and calcium channel blocker based regimens compared with placebo (fig 2).
Over our 3-week sampling period, we found higher intra-patient variability in the PI-based regimens compared to the NNRTIs; a similar finding to the retrospective summary provided by Fabbiani and colleagues [ 47].
12 A recent analysis of real-world data in the US by CVS Health found a four-fold increase in the discontinuation of SOF-based regimens compared to the discontinuation rate published in clinical trials.
Clinical trials in adults [31], [32] and observational studies in children [33], [34], [35] showed higher rates of virologic failure with nevirapine-based regimens compared to efavirenz-based regimens, consistent with our findings.
This study showed OS rates of 38 weeks for patients who received cytotoxic-based regimens compared to 27 weeks for patients who received non-cytotoxic treatment.
We considered particularly relevant to evaluate the efficacy of NNRTI-based regimens compared to PI-based regimens with or without ritonavir boost.
