| Effectiveness of boosted protease inhibitor-based regimens in HIV type 1-infected patients who experienced virological failure with NNRTI-based antiretroviral therapy in a resource-limited setting. | |
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MedLine Citation:
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PMID: 20156097 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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A number of patients have experienced treatment failure while receiving non-nucleoside reverse transcriptase inhibitor (NNRTI)-based antiretroviral therapy (ART), particularly in resource-limited countries. The need remains for clinical data on protease inhibitor (PI)-based regimens in these patients. A retrospective cohort study was conducted among HIV-1-infected patients who had failed NNRTI-based regimens, were naive to protease inhibitors (PIs), and subsequently initiated a salvage PI-based regimen between January 2004 and December 2006. The study period ended on 30 December 2007. One hundred and forty patients received a single-boosted PI +/- optimized background regimen (OBR) and 64 received double-boosted PIs. The median (IQR) duration of follow-up was 19 (13-29) months. The overall virological failure rate at 24 months was 15.2%. No statistically significant difference was detected between the two regimen groups (single-boosted PI +/- OBR 16.4% vs. double-boosted PIs 12.5%, log rank p = 0.818). At the end of the study, the median (IQR) change in CD4 cell counts for patients in the double-boosted PI group was higher than for patients in the single-boosted PI +/- OBR group [149 (53-322) vs. 105 (23-199), respectively, p = 0.012]. Patients receiving double-boosted PI regimens displayed a higher frequency of hypertriglyceridemia than those patients who received a single boosted PI +/- OBR (31% vs. 11%, respectively, p = 0.001). Boosted PI-based regimens showed acceptable virological outcomes among patients who had failed NNRTI-based ART. In the subgroup analysis, patients who received double-boosted PIs demonstrated a superior immunological response but not better virological outcomes compared to the single-boosted PI +/- OBR group. |
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Authors:
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Krittaecho Siripassorn; Weerawat Manosuthi; Suthat Chottanapund; Aranya Pakdee; Siriwan Sabaitae; Wisit Prasithsirikul; Preecha Tunthanathip; Kiat Ruxrungtham; |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: AIDS research and human retroviruses Volume: 26 ISSN: 1931-8405 ISO Abbreviation: AIDS Res. Hum. Retroviruses Publication Date: 2010 Feb |
Date Detail:
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Created Date: 2010-02-16 Completed Date: 2010-04-21 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8709376 Medline TA: AIDS Res Hum Retroviruses Country: United States |
Other Details:
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Languages: eng Pagination: 139-48 Citation Subset: IM; X |
Affiliation:
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Bamrasnaradura Infectious Diseases Institute , Nonthaburi, Thailand. krittaecho@bamras.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Anti-HIV Agents / therapeutic use* Antiretroviral Therapy, Highly Active / methods* CD4 Lymphocyte Count Cohort Studies Developing Countries Female HIV Infections / drug therapy* HIV Protease Inhibitors / therapeutic use* HIV-1 / isolation & purification Humans Male Middle Aged Retrospective Studies Reverse Transcriptase Inhibitors / therapeutic use* Salvage Therapy Treatment Failure Treatment Outcome Viral Load Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Anti-HIV Agents; 0/HIV Protease Inhibitors; 0/Reverse Transcriptase Inhibitors |
| Investigator | |
Investigator/Affiliation:
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Boonchai Kowadisaiburana / ; Khobchok Worapanarat / ; Narongsak Hengphadpanadamrong / ; Natpatu Sanguanwongse / ; Patama Sutha / ; Wannarat Amornnimit / ; Wiroj Mankhatitham / |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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