Document Detail


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.
MedLine Citation:
PMID:  20156097     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Krittaecho Siripassorn; Weerawat Manosuthi; Suthat Chottanapund; Aranya Pakdee; Siriwan Sabaitae; Wisit Prasithsirikul; Preecha Tunthanathip; Kiat Ruxrungtham;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  AIDS research and human retroviruses     Volume:  26     ISSN:  1931-8405     ISO Abbreviation:  AIDS Res. Hum. Retroviruses     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-16     Completed Date:  2010-04-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8709376     Medline TA:  AIDS Res Hum Retroviruses     Country:  United States    
Other Details:
Languages:  eng     Pagination:  139-48     Citation Subset:  IM; X    
Affiliation:
Bamrasnaradura Infectious Diseases Institute , Nonthaburi, Thailand. krittaecho@bamras.org
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MeSH Terms
Descriptor/Qualifier:
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:
0/Anti-HIV Agents; 0/HIV Protease Inhibitors; 0/Reverse Transcriptase Inhibitors
Investigator
Investigator/Affiliation:
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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