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Youle, M. et al.

Youle, Tyrer, Fisher, Lampe, Wilson, Ransom, Story, Mocroft, Loveday, Johnson, Phillips,

Brief report: two-year outcome of a multidrug regimen in patients who did not respond to a protease inhibitor regimen.

In most studies, people who have not responded virologically to a protease inhibitor (PI)-containing regimen have tended to experience poor virologic responses to subsequent regimens. We describe the 2-year viral load, CD4 count, and clinical outcome of a multidrug regimen used in 60 people who had not responded virologically to a PI-containing regimen. At baseline, median CD4 count was 126/mm(3) (nadir 30/mm(3) ) and median viral load was 320,000 copies/mL. A median of five antiretroviral drugs had previously been used, of which a median of two were PIs. Of these patients, 16% had previously used another nonnucleoside reverse transcriptase inhibitor besides efavirenz. The multidrug regimen (median 5 drugs) started most commonly included efavirenz (100%), at least one PI (92%, usually indinavir/ritonavir), didanosine (78%), and hydroxyurea (74%). At year 2, 5 patients had died and 5 had no measure available. Nine patients developed a new AIDS event and 10 patients were known to have stopped all antiretroviral therapy. Thirty-one patients (52% of the whole group, 72% of those remaining on therapy with viral load value available) had viral load <50 copies/mL. Thus, a substantial proportion of patients who had failed to respond virologically to PI-containing regimens can achieve profound and sustained virologic suppression with a multidrug regimen.[1]

References

Brief report: two-year outcome of a multidrug regimen in patients who did not respond to a protease inhibitor regimen. Youle, M., Tyrer, M., Fisher, M., Lampe, F., Wilson, D., Ransom, D., Story, A., Mocroft, A., Loveday, C., Johnson, M.A., Phillips, A.N. J. Acquir. Immune Defic. Syndr. (2002) [Pubmed]

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