Cahn salió con su equipo internacional a romper con tapones de punta al maldito HIV

El argentino Pedro Cahn, infectólogo de nota, con su equipo internacional, hoy, nos dieron una excelente noticia al informar que con dos fármacos, en vez de tres, se puede combatir el SIDA. Felicitaciones, realmente. Son inolvidables...! Veamos The Lancet Infectious Diseases, Early Online Publication, 28 April 2014doi:10.1016/S1473-3099(14)70736-4Cite or Link Using DOIThis article can be found in the following collections: Infectious Diseases (Anti-infective therapy, HIV/AIDS)Copyright © 2014 Elsevier Ltd All rights reserved. Dual therapy with lopinavir and ritonavir plus lamivudine versus triple therapy with lopinavir and ritonavir plus two nucleoside reverse transcriptase inhibitors in antiretroviral-therapy-naive adults with HIV-1 infection: 48 week results of the randomised, open label, non-inferiority GARDEL trial Original Text Dr Pedro Cahn MD a , Jaime Andrade-Villanueva MD b, José R Arribas MD c, José M Gatell MD d, Javier R Lama MD e, Michael Norton MD f, Patricia Patterson MD a, Juan Sierra Madero MD g, Omar Sued MD a, Maria Inés Figueroa MD a, Maria José Rolon MD a, on behalf of the GARDEL Study Group† Summary Background Daily oral triple therapy is effective at halting HIV disease progression, but can have toxic effects and is costly. We investigated whether dual therapy with lopinavir and ritonavir plus lamivudine is non-inferior to standard triple therapy. Methods The GARDEL study (Global AntiRetroviral Design Encompassing Lopinavir/r and Lamivudine vs LPV/r based standard therapy) is a 48 week, phase 3, randomised, controlled, open-label, non-inferiority trial in antiretroviral-therapy-naive adults (age ≥18 years) with documented HIV-1 RNA viral load of at least 1000 copies per mL. The study was done at 19 centres in six countries. Patients were randomly assigned (1:1) to dual therapy or triple therapy by sealed envelopes, in blocks of four, stratified by baseline viral load (<100 000 vs ≥100 000 copies per mL). Dual therapy consisted of lopinavir 400 mg and ritonavir 100 mg plus lamivudine 150 mg, both twice daily. Triple therapy consisted of lopinavir 400 mg and ritonavir 100 mg twice daily and lamivudine or emtricitabine plus another nucleoside reverse transcriptase inhibitor (NRTI) in fixed-dose combination. Efficacy was analysed in all participants who received at least one dose of study drug. The primary endpoint was virological response rate, defined as the proportion of patients with HIV RNA less than 50 copies per mL at 48 weeks. Dual therapy was classed as non-inferior to triple therapy if the lower bound of the 95% CI for the difference between groups was no lower than −12%. Patients and investigators were unmasked to treatment allocation. This study is registered with, number NCT01237444. Findings Between Dec 10, 2010, and May 15, 2012, 217 patients were randomly assigned to the dual-therapy group and 209 to the triple-therapy group. 198 patients in the dual-therapy group and 175 in the triple-therapy group completed 48 weeks of treatment. At week 48, 189 patients (88·3%) in the dual-therapy group and 169 (83·7%) in the triple-therapy group had viral response (difference 4·6%, 95% CI −2·2 to 11·8; p=0·171). Patients with baseline viral load of at least 100 000 copies per mL showed similar results (87·2% vs 77·9%, respectively; difference 9·3%, 95% CI −2·8 to 21·5; p=0·145). Toxicity-related or tolerability-related discontinuations were more common in the triple-therapy group (n=10 [4·9%]) than in the dual-therapy group (n=1 [0·4%]; difference 4·5%, 95% CI −8·1 to −0·9; p=0·011). 65 adverse events in the dual-therapy group and 88 in the triple-therapy group were possibly or probably drug related (p=0·007). Two serious adverse events occurred, both in the dual-therapy arm, one of which (a case of gastritis) was reported as possibly or probably related to drug treatment. Interpretation Dual therapy with lopinavir and ritonavir plus lamivudine regimen warrants further clinical research and consideration as a potential therapeutic option for antiretroviral-therapy-naive patients. Funding Fundación Huésped and AbbVie. a Clinical Research Department, Fundación Huésped, Buenos Aires, Argentina b HIV Unit, Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Guadalajara, Mexico c Internal Medicine, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain d Infectious Unit, Hospital Clínic/IDIBAPS, University of Barcelona, Barcelona, Spain e Asociación Civil Impacta Salud y Educación, Lima, Peru f Medical Affairs Therapeutic Area, Virology and Nanotechnology, Global Pharmaceutical Research and Development, AbbVie, Chicago, IL, USA g Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico Correspondence to: Dr Pedro Cahn, Fundación Huésped, Buenos Aires, C1202ABB Argentina † Members listed at end of paper

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