Study to Evaluate the Activity and Tolerability of Lopinavir/Ritonavir and Lamivudine Bitherapy in HIV Patients With Viral Suppression (OLE)

• Proportion of patients with no viral failure [ Time Frame: 48 weeks ] [ Designated as safety issue: No ]
  defined as two viral loads above 50 copies/ml. Patients lost to follow-up or changing treatment will not be taken into account for this analysis
• Proportion of patients with no therapeutical failure [ Time Frame: 48 weeks ] [ Designated as safety issue: No ]
  defined as in the primary outcome but with two viral loads above 400 copies/ml, not 50 as in the primary outcome.
• Proportion of patients with no viral failure [ Time Frame: 48 weeks ] [ Designated as safety issue: No ]
  defined as two viral loads above 400 copies/ml
• Time to viral failure [ Time Frame: 48 weeks ] [ Designated as safety issue: No ]
  Two different analysis will be carried out: with 50 copies/ml threshold and with 400 copies/ml threshold
• Proportion of patients with blips [ Time Frame: 48 weeks ] [ Designated as safety issue: No ]
  Defined as one viral load above 50 and below 400 copies/ml with next viral load below 50 copies/ml
• Change from baseline CD4 [ Time Frame: 48 weeks ] [ Designated as safety issue: No ]
• Lipidic profile change from baseline [ Time Frame: 48 weeks ] [ Designated as safety issue: Yes ]
• Creatinine clearance change from baseline [ Time Frame: 48 weeks ] [ Designated as safety issue: Yes ]
• Proportion of patients with proximal tubular renal disfunction [ Time Frame: 48 weeks ] [ Designated as safety issue: Yes ]
• Lipodystrophy changes from baseline [ Time Frame: 48 weeks ] [ Designated as safety issue: Yes ]
  evaluated using two questionnaires: lipoatrophy and fat accumulation
• Adherence to treatment [ Time Frame: 48 weeks ] [ Designated as safety issue: No ]
• Mortality and progression to AIDS [ Time Frame: 48 weeks ] [ Designated as safety issue: No ]
• Adverse events per treatment branch [ Time Frame: 48 weeks ] [ Designated as safety issue: Yes ]
• Proportion of patients switching study treatment due to an adverse event [ Time Frame: 48 weeks ] [ Designated as safety issue: Yes ]
• Proportion of serious adverse events related to treatment [ Time Frame: 48 weeks ] [ Designated as safety issue: Yes ]

This is a prospective, open controlled trial in which HIV-1 with viral suppression patients will be randomized to continue with their current treatment (lopinavir/ritonavir plus emtricitabine or lamivudine plus any nucleoside analogue reverse transcriptase inhibitor) or to simplify to lopinavir/ritonavir plus lamivudine.

Randomization will be stratified according to the values of nadir CD4 and time of viral suppression.

• Experimental: simplification
  Lopinavir/ritonavir (400/100 BID) plus lamivudine (300 QD)
  Intervention: Drug: antiretroviral treatment
• Active Comparator: Continue with current treatment
  Intervention: Drug: antiretroviral treatment

Inclusion Criteria:

• Patients of either sex (female or male) and 18 years or older.
• Patients seropositive for HIV-1 using standard diagnostic criteria.
• There is confirmation of viral load to be lower than 50 cop/ml during the 6 previous months to inclusion. The requirement is to have at least two viral loads lower than 50 cop/mL separated by 6 months and no one >50cop/mL during the 6 months before inclusion.
• Patients on continuous HAART consisting of LPV/r, emtricitabine (FTC) or 3TC (lamivudine) and an NRTI for at least 2 months before being randomized in this study.
• Patients who are clinically stable, in the opinion of the investigator, at entry into the study (clinical status and chronic medication must not have not been modified at least 14 days prior to randomization). Patients receiving therapy for an active opportunistic infection are eligible for enrollment if the above criteria are met. Standard prophylaxis of opportunistic infections is permitted.

Exclusion Criteria:

• Pregnancy, nursing, or planned pregnancy during the study period.
• Previous failure with regimens including a protease inhibitor (PI) or 3TC/FTC.
• Known resistance mutations to PIs or 3TC/FTC.
• Patients with an active opportunistic infection or malignancy. Patients with a stable chronic opportunistic infection may be included in the study.
• Any disease or history of disease which, in the opinion of the investigator, might confound the results of the study or pose additional risk to patient treatment.
• Patients diagnosed with visceral Kaposi's sarcoma (KS), patients with lymphoedema secondary to cutaneous KS or cutaneous or palatine KS who have been treated with systemic immunosuppressive therapy must also be excluded.
• Patients with chronic hepatitis B on treatment with tenofovir + 3TC/FTC