Objectives : to evaluate the efficacy and safety of a dual therapy of raltegravir (RAL) and ritonavir-boosted protease inhibitor (PIr) in patients with resistance and/or NRTI-related adverse events. Methods Cohort of HIV infected adults starting a dual therapy with RAL plus PIr from Jan 2008 to Sep 2009 in 3 Italian HIV reference centres. Patients changing ARV for resistance and/or NRTI-related adverse events were included. Demografic, epidemiological, labora- tory and immunological-virological data were collected using medical report database 60 Infection 38 · 2010 · Supplement I ICAR 2010 – Posters Results : 24 triple class-experienced patients were included: male 79%, median age 49 years, median baseline CD4 346/mmc, 83% of the pa- tients had HIV RNA below 40 copies/ml. HIV genotipic resistance test were available in 18/24 patients: all of them showed a complete resistance to NRTI drugs. At baseline 19 patients were receiving 2 NRTI+ PI/r, 4 2NRTI+NNRTI. Reasons for change of the previous regimen were virologic failure (n=4), liver toxicity (n=3), renal failure (n=3), cardiovascular events (n=2), simplification (n=12). Patients started therapy with RAL + DRV/r (n=18), TPV/r (n=2), LPV/r (n=2), ATV/r (n=2). After a median follow-up of 48 weeks, treatment interruption oc- curred in 1 patient lost to follow-up. At the latest visit, median CD4 was 421/mmc and HIV RNA was below 40 copies/ml in all patients. No adverse events were observed, hepatic and renal function has been improved in patients with previous observed failure. Conclusion : In this antiretroviral-experienced population a dual ther- apy of RAL + PI/r seems an attractive regimen in patients with resis- tance and/or NRTI-related adverse events. Limitation of this study is the low number of patients included. Further randomized clinical tri- als are needed in order to confirm the efficacy and safety of this strat- egy
Raltegravir plus a boosted protease inhibitor: experience in patients with resistance and/or NRTI-re-lated adverse events
D. Segala
;
2010
Abstract
Objectives : to evaluate the efficacy and safety of a dual therapy of raltegravir (RAL) and ritonavir-boosted protease inhibitor (PIr) in patients with resistance and/or NRTI-related adverse events. Methods Cohort of HIV infected adults starting a dual therapy with RAL plus PIr from Jan 2008 to Sep 2009 in 3 Italian HIV reference centres. Patients changing ARV for resistance and/or NRTI-related adverse events were included. Demografic, epidemiological, labora- tory and immunological-virological data were collected using medical report database 60 Infection 38 · 2010 · Supplement I ICAR 2010 – Posters Results : 24 triple class-experienced patients were included: male 79%, median age 49 years, median baseline CD4 346/mmc, 83% of the pa- tients had HIV RNA below 40 copies/ml. HIV genotipic resistance test were available in 18/24 patients: all of them showed a complete resistance to NRTI drugs. At baseline 19 patients were receiving 2 NRTI+ PI/r, 4 2NRTI+NNRTI. Reasons for change of the previous regimen were virologic failure (n=4), liver toxicity (n=3), renal failure (n=3), cardiovascular events (n=2), simplification (n=12). Patients started therapy with RAL + DRV/r (n=18), TPV/r (n=2), LPV/r (n=2), ATV/r (n=2). After a median follow-up of 48 weeks, treatment interruption oc- curred in 1 patient lost to follow-up. At the latest visit, median CD4 was 421/mmc and HIV RNA was below 40 copies/ml in all patients. No adverse events were observed, hepatic and renal function has been improved in patients with previous observed failure. Conclusion : In this antiretroviral-experienced population a dual ther- apy of RAL + PI/r seems an attractive regimen in patients with resis- tance and/or NRTI-related adverse events. Limitation of this study is the low number of patients included. Further randomized clinical tri- als are needed in order to confirm the efficacy and safety of this strat- egyI documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
