TITLE

Role of lopinavir/ritonavir in the treatment of SARS: initial virological and clinical findings

AUTHOR(S)
Chu C M; Cheng V C C; Hung I F N; Wong M M L; Chan K H; Chan K S; Kao R Y T; Poon L L M; Wong C L P; Guan Y; Peiris J S M; Yuen K Y
PUB. DATE
March 2004
SOURCE
Thorax;Mar2004, Vol. 59 Issue 3, p252
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
BACKGROUND: The clinical response of patients with severe acute respiratory syndrome (SARS) to a combination of lopinavir/ritonavir and ribavirin was examined after establishing the in vitro antiviral susceptibility of the SARS associated coronavirus to a panel of antiviral agents. METHODS: The in vitro susceptibility of the prototype of SARS associated coronavirus to a panel of nucleoside analogues and protease inhibitors currently licensed for clinical use was studied. Forty one patients with SARS followed for 3 weeks were treated with a combination of lopinavir/ritonavir and ribavirin. The clinical progress and virological outcomes were monitored and compared with 111 patients treated with ribavirin only who served as historical controls. RESULTS: In vitro antiviral activity against SARS associated coronavirus was demonstrated for lopinavir and ribavirin at concentrations of 4 micro g/ml and 50 micro g/ml, respectively, only at 48 hours. The adverse clinical outcome (ARDS or death) was significantly lower in the treatment group than in the historical controls (2.4% v 28.8%, p<0.001) at day 21 after the onset of symptoms. The adverse outcome remained significantly lower in the treatment group than in the controls-both those diagnosed early (p<0.001) and those diagnosed later in the course of the epidemic (p = 0.002)-but there was no significant difference in adverse outcome rates between the two time periods (p = 0.548). No time related difference in outcome was observed in the control groups. A reduction in steroid usage and nosocomial infections was seen in patients initially treated with lopinavir/ritonavir, and these patients had a decreasing viral load and rising peripheral lymphocyte count. Multivariate analysis showed that age, hepatitis B carrier status, and lack of treatment with this antiviral combination were independent predictors of an adverse outcome. Lopinavir/ritonavir treatment was associated with a better outcome even when adjusted for baseline lactate dehydrogenase level. CONCLUSIONS: The apparent favourable clinical response with lopinavir/ritonavir and ribavirin supports further randomised placebo controlled trials in patients with SARS.
ACCESSION #
12409817

 

Related Articles

  • Is the Sexual Behaviour of HIV Patients on Antiretroviral therapy safe or risky in Sub-Saharan Africa? Meta-Analysis and Meta-Regression. Berhan, Asres; Berhan, Yifru // AIDS Research & Therapy;2012, Vol. 9, p14 

    Background: Reports on the sexual behavior of people on antiretroviral therapy (ART) are inconsistent. We selected 14 articles that compared the sexual behavior of people with and without ART for this analysis. Methods: We included both cross-sectional studies that compared different...

  • The Relationship Between Diabetes and Infectious Hospitalizations in Renal Transplant Recipients. Lansang, M. Cecilia; Ma, Linan; Schold, Jesse D.; Meier-Kriesche, Herwig-Ulf; Kaplan, Bruce // Diabetes Care;Jul2006, Vol. 29 Issue 7, p1659 

    The article presents the results of a case study on the relationship between diabetes and infectious hospitalizations in renal transplant recipients. The outcome of interest was infection requiring hospitalization occurring in the posttransplant period. The survival time until development of...

  • Iterative Thoracentesis as First-Line Treatment of Complicated Parapneumonic Effusion. Letheulle, Julien; Tattevin, Pierre; Saunders, Lauren; Kerjouan, Mallorie; Léna, Hervé; Desrues, Benoit; Le Tulzo, Yves; Jouneau, Stéphane // PLoS ONE;Jan2014, Vol. 9 Issue 1, p1 

    Rationale: Optimal management of complicated parapneumonic effusions (CPPE) remains controversial. Objectives: to assess safety and efficacy of iterative therapeutic thoracentesis (ITTC), the first-line treatment of CPPE in Rennes University Hospital. Methods: Patients with CPPE were identified...

  • Early enteral feeding and nosocomial sepsis in very low birthweight infants. Flidel-Rimon, O.; Friedman, S.; Lev, E.; Juster-Reicher, A.; Amitay, M.; Shinwell, E. S. // Archives of Disease in Childhood -- Fetal & Neonatal Edition;Jul2004, Vol. 89 Issue 4, pf289 

    Background: The interrelations between early enteral feeding, necrotising enterocolitis (NEC), and nosocomial sepsis (NS) remain unclear. Objective: To evaluate the effect of age at the introduction of enteral feeding on the incidence of NS and NEC in very low birthweight (VLBW < 1500 g)...

  • Emergency department visits caused by adverse drug events: results of a French survey. Queneau, Patrice; Bannwarth, Bernard; Carpentier, Françoise; Guliana, Jean-Michel; Bouget, Jacques; Trombert, Béatrice; Leverve, Xavier; Lapostolle, Frédéric; Borron, Stephen W.; Adnet, Frédéric; Carpentier, Françoise; Trombert, Béatrice; Lapostolle, Frédéric; Adnet, Frédéric; Association Pédagogique Nationale pour l'Enseignement de la Thérapeutique (APNET) // Drug Safety;2007, Vol. 30 Issue 1, p81 

    Background: Adverse drug events (ADEs) are a substantial cause of hospital admissions. However, little is known about the incidence, preventability and severity of ADEs resulting in emergency department visits. To address this issue, we conducted a prospective survey in emergency...

  • Injection Drug Use Is a Risk Factor for HCV Infection in Urban Egypt. Jimenez, Adela Paez; Mohamed, Mostafa K.; Eldin, Noha Sharaf; Seif, Hasnaa Abou; El Aidi, Said; Sultan, Yehia; Elsaid, Nasr; Rekacewicz, Claire; El-Hoseiny, Mostafa; El-Daly, May; Abdel-Hamid, Mohamed; Fontanet, Arnaud // PLoS ONE;2009, Vol. 4 Issue 9, p1 

    Objective: To identify current risk factors for hepatitis C virus (HCV) transmission in Greater Cairo. Design and Setting: A 1:1 matched case-control study was conducted comparing incident acute symptomatic hepatitis C patients in two ''fever'' hospitals of Greater Cairo with two control groups:...

  • Azacitidine in patients with WHO-defined AML - Results of 155 patients from the Austrian Azacitidine Registry of the AGMT-Study Group. Pleyer, Lisa; Stauder, Reinhard; Burgstaller, Sonja; Schreder, Martin; Tinchon, Christoph; Pfeilstocker, Michael; Steinkirchner, Susanne; Melchardt, Thomas; Mitrovic, Martina; Girschikofsky, Michael; Lang, Alois; Krippl, Peter; Sliwa, Thamer; Egle, Alexander; Linkesch, Werner; Voskova, Daniela; Angermann, Hubert; Greil, Richard // Journal of Hematology & Oncology;2013, Vol. 6 Issue 1, p1 

    Objective: The Austrian Azacitidine Registry is a multi-center database (ClinicalTrials.gov: NCT01595295). The nature and intent of the registry was to gain a comprehensive view of the use, safety and efficacy of the drug in a broad range of AML-patients treated in real-life scenarios. Patients...

  • State-Specific Health-Care--Associated Infections Summary Data Report.  // MMWR: Morbidity & Mortality Weekly Report;5/28/2010, Vol. 59 Issue 20, p632 

    The article reports on the publication of the first state-specific health-care-associated infections (HAIs) summary data report by the U.S. Centers for Disease Control and Prevention's (CDC's) Division of Healthcare Quality Promotion.

  • Iatrogenic illness. Ebell, Mark H. // Cortlandt Forum;11/25/96, Vol. 9 Issue 11, p46 

    Presents an account of the author's experience of diagnosing a patient with an iatrogenic disease. Activities as a solo practitioner; Life style; Treatment of a patient complaining of chest pain with exertional features.

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sign out of this library

Other Topics