Tags

Type your tag names separated by a space and hit enter

Low rate of virological failure and maintenance of susceptibility to HIV-1 protease inhibitors with first-line lopinavir/ritonavir-based antiretroviral treatment in clinical practice.
J Med Virol. 2010 Dec; 82(12):1996-2003.JM

Abstract

Protease inhibitor (PI)-resistant HIV-1 has hardly ever been detected at failed boosted PI-based first-line antiretroviral regimens in clinical trials. However, this phenomenon has not been investigated in clinical practice. To address this gap, data from patients starting a first-line lopinavir/ritonavir (LPV/rtv)-based therapy with available baseline HIV-1 RNA load, a viral genotype and follow-up viral load after 3 and 6 months of treatment were extracted from the Italian Antiretroviral Resistance Cohort Analysis (ARCA) observational database. Based on survival analysis, 39 (7.1%) and 43 (7.8%) of the 548 examined patient cases had an HIV-1 RNA >500 and >50 copies/ml, respectively, after 6 months of treatment. Cox proportional hazard models detected baseline HIV-1 RNA (RH 1.79, 95%CI 1.10-2.92 per 1-log(10) increase, P=0.02) and resistance to the nucleoside backbone (RH 1.04, 95%CI 1.02-1.06 per 10-point increase using the Stanford HIVdb algorithm, P<0.001) as independent predictors of HIV-1 RNA at >500 copies/ml, but not at the >50 copies/ml cutoff criteria. Higher baseline viral load, older patient age, heterosexual route of infection and use of tenofovir/emtricitabine were predictors of failure at month 3 using the 50-copy and/or 500-copy threshold. Resistance to LPV/rtv did not occur or increase in any of the available 36 follow-up HIV-1 genotypes. Resistance to the nucleoside backbone (M184V) developed in four cases. Despite the likely differences in patient population and adherence, both the low rate of virological failure and the lack of development of LPV/rtv resistance documented in clinical trials are thus confirmed in clinical practice.

Authors+Show Affiliations

Clinic of Infectious Diseases, Catholic University of Sacred Heart, Rome, Italy. ahnven@yahoo.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20981785

Citation

Prosperi, Mattia C F., et al. "Low Rate of Virological Failure and Maintenance of Susceptibility to HIV-1 Protease Inhibitors With First-line Lopinavir/ritonavir-based Antiretroviral Treatment in Clinical Practice." Journal of Medical Virology, vol. 82, no. 12, 2010, pp. 1996-2003.
Prosperi MC, Zazzi M, Punzi G, et al. Low rate of virological failure and maintenance of susceptibility to HIV-1 protease inhibitors with first-line lopinavir/ritonavir-based antiretroviral treatment in clinical practice. J Med Virol. 2010;82(12):1996-2003.
Prosperi, M. C., Zazzi, M., Punzi, G., Monno, L., Colao, G., Corsi, P., Di Giambenedetto, S., Meini, G., Ghisetti, V., Bonora, S., Pecorari, M., Gismondo, M. R., Bagnarelli, P., Carli, T., & De Luca, A. (2010). Low rate of virological failure and maintenance of susceptibility to HIV-1 protease inhibitors with first-line lopinavir/ritonavir-based antiretroviral treatment in clinical practice. Journal of Medical Virology, 82(12), 1996-2003. https://doi.org/10.1002/jmv.21927
Prosperi MC, et al. Low Rate of Virological Failure and Maintenance of Susceptibility to HIV-1 Protease Inhibitors With First-line Lopinavir/ritonavir-based Antiretroviral Treatment in Clinical Practice. J Med Virol. 2010;82(12):1996-2003. PubMed PMID: 20981785.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low rate of virological failure and maintenance of susceptibility to HIV-1 protease inhibitors with first-line lopinavir/ritonavir-based antiretroviral treatment in clinical practice. AU - Prosperi,Mattia C F, AU - Zazzi,Maurizio, AU - Punzi,Grazia, AU - Monno,Laura, AU - Colao,Grazia, AU - Corsi,Paola, AU - Di Giambenedetto,Simona, AU - Meini,Genny, AU - Ghisetti,Valeria, AU - Bonora,Stefano, AU - Pecorari,Monica, AU - Gismondo,Maria Rita, AU - Bagnarelli,Patrizia, AU - Carli,Tiziana, AU - De Luca,Andrea, AU - ,, PY - 2010/10/29/entrez PY - 2010/10/29/pubmed PY - 2011/2/24/medline SP - 1996 EP - 2003 JF - Journal of medical virology JO - J Med Virol VL - 82 IS - 12 N2 - Protease inhibitor (PI)-resistant HIV-1 has hardly ever been detected at failed boosted PI-based first-line antiretroviral regimens in clinical trials. However, this phenomenon has not been investigated in clinical practice. To address this gap, data from patients starting a first-line lopinavir/ritonavir (LPV/rtv)-based therapy with available baseline HIV-1 RNA load, a viral genotype and follow-up viral load after 3 and 6 months of treatment were extracted from the Italian Antiretroviral Resistance Cohort Analysis (ARCA) observational database. Based on survival analysis, 39 (7.1%) and 43 (7.8%) of the 548 examined patient cases had an HIV-1 RNA >500 and >50 copies/ml, respectively, after 6 months of treatment. Cox proportional hazard models detected baseline HIV-1 RNA (RH 1.79, 95%CI 1.10-2.92 per 1-log(10) increase, P=0.02) and resistance to the nucleoside backbone (RH 1.04, 95%CI 1.02-1.06 per 10-point increase using the Stanford HIVdb algorithm, P<0.001) as independent predictors of HIV-1 RNA at >500 copies/ml, but not at the >50 copies/ml cutoff criteria. Higher baseline viral load, older patient age, heterosexual route of infection and use of tenofovir/emtricitabine were predictors of failure at month 3 using the 50-copy and/or 500-copy threshold. Resistance to LPV/rtv did not occur or increase in any of the available 36 follow-up HIV-1 genotypes. Resistance to the nucleoside backbone (M184V) developed in four cases. Despite the likely differences in patient population and adherence, both the low rate of virological failure and the lack of development of LPV/rtv resistance documented in clinical trials are thus confirmed in clinical practice. SN - 1096-9071 UR - https://www.unboundmedicine.com/medline/citation/20981785/Low_rate_of_virological_failure_and_maintenance_of_susceptibility_to_HIV_1_protease_inhibitors_with_first_line_lopinavir/ritonavir_based_antiretroviral_treatment_in_clinical_practice_ L2 - https://doi.org/10.1002/jmv.21927 DB - PRIME DP - Unbound Medicine ER -