Eric S. Daar, MD; Ann A. Collier, MD; Camlin Tierney, PhD
Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M10-1780.
Daar ES, Collier AA, Tierney C. Atazanavir Plus Ritonavir or Efavirenz as Part of a 3-Drug Regimen for Initial Treatment of HIV-1. Ann Intern Med. 2011;155:403. doi: 10.7326/0003-4819-155-6-201109200-00017
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Published: Ann Intern Med. 2011;155(6):403.
Dr. Flandre raises important points regarding the ACTG Study A5202 results; however, the abstract's conclusion does not stand alone. The Results section of the abstract and the Results and Discussion sections of the manuscript state that the equivalence boundary was not met. We do believe that the similarity in response rates is relevant to clinicians considering these treatment options. Differences in baseline HIV-1 RNA values have been addressed in a secondary analysis adjusting for this as continuous and categorical variables (<50 000 copies/mL, 50 000 to <100 000 copies/mL, 100 000 to <500 000 copies/mL, or ≥500 000 copies/mL), with the treatment effect estimate showing similar results to the primary analysis. The HRs and 95% CIs when baseline HIV-1 RNA was analyzed as continuous and categorical variables were 1.11 (0.81 to 1.54) and 1.06 (0.77 to 1.47) for abacavir–lamivudine and 1.01 (0.70 to 1.46) and 1.04 (0.72 to 1.51) for tenofovir disoproxil fumarate–emtricitabine, respectively.
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