Ladisa N, Perulli LM, Angarano G, Pastore G; International Conference on AIDS.
Int Conf AIDS. 2000 Jul 9-14; 13: abstract no. WePeB4158.
N. Ladisa, University of Bari, Piazza G Cearsare n11, Bari 70126, Italy, Tel.: +39 080 559 2472, Fax: +39 080 544 8334, E-mail: trial@clininf.uni.ba.it
Background: The role of NNRTIs for first-line therapy, for management of protease inhibitor (PI)-treated patients with metabolic alterations, and for salvage regimens were studied. The aim of the retrospective study is to ascertain if salvage regimens with 2 nucleoside reverse transcriptase inhibitors (NRTIs) plus 1NNRTI plus 1PI are as effective as dual PI-based regimens for HIV patients failing first PI-therapy. Methods: We analyzed 15 HIV patients failed first PI therapy (pVL decrease >1 log10 below baseline or initial undetectable HIV-RNA with return to baseline): 10 patients received saquinavir (hard-gel), 3 indinavir and 2 ritonavir plus 2 NRTIs for a mean of 16 months before virologic failure. No patients received NNRTI. Before PI therapy, 4 patients were naive and 11 were NRTI experienced. Results: Nine non-randomized patients received salvage therapy with 2NRTI + 1NNRTI + 1PI and 6 patients had second-line therapy with 2 NRTI + 2 PI. There were no significant differences in age, sex, risk factor, previous therapy, CD4 and viral load when changing therapy. The results of the two groups are reported in Table 1. CD4 increase pVL decrease undectable VL (cells/mmc) (log10 copies/ml) (%pt.) 3 mos 6 mos 3 mos 6 mos 3 mos 6 mos 1NNRTI + 1PI + 2NRTI 110 129 2.28 1.67 71 40 2PI + 2NRTI 86 79 1.89 1.18 20 25 In patients treated with NNRTI regimens, mild to moderate metabolic alterations were seen in 30% of cases while those treated with 2 PI-based regimens showed alterations in 40% of cases together with perioral paresthesia, lypodystrophia, gastroenterologic disturbances and dysgeusia. Conclusions: Greater pVL reductions, increases in absolute CD4 and patient numbers with undectable pVL were observed in 1NNRTI + 1PI + 2NRTI-treated patients than in those with dual PI-based regimens. Noncompliance is probably the main risk factor for patients treated with dual PI therapy due to greater side effects.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- HIV Infections
- HIV Seropositivity
- Humans
- Indinavir
- Protease Inhibitors
- Retrospective Studies
- Reverse Transcriptase Inhibitors
- Ritonavir
- Salvage Therapy
- Saquinavir
- Viral Load
Other ID:
UI: 102240371
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