Tipranavir/T20-based salvage regimens highly effective and durable against HIV-1 with evidence for genotypic predictability of response in clinical practice

Gupta, R. K.; Loveday, Clive; Kalidindi, U.; Lechelt, M.; Skinner, Celia; Orkin, Chloe
September 2007
International Journal of STD & AIDS;Sep2007, Vol. 18 Issue 9, p630
Academic Journal
Escalating drug resistance in treatment-experienced HIV-1-infected patients has made management increasingly difficult. In clinical trials, tipranavir (TPV) has produced potent and durable responses in such patients, although experience in clinical cohorts is limited. A retrospective clinical case review was undertaken of triple-class experienced HIV-1-infected patients receiving optimized boosted TPV-containing regimens and T20 with up to 108 weeks follow-up. Antiretroviral therapy (ART) resistance profiles were characterized using International Aids Society (IAS)-USA scoring and 'TPV resistance score' (TPV-RS) at baseline and failure. Five of 12 patients had undetectable virus (<50 copies/mL) after median 84 weeks (range 60–108), and 1/12 < had 700 copies/mL after 40 weeks. Six of 12 patients failed after 36 (range 12–48) weeks and were more likely to have ≥3 TPV-RS mutations than non-failures (P = 0.06). Presence of a major IAS-USA mutation at baseline was strongly associated with absence of a 1 log viral load drop at 24 weeks (P = 0.02). TPV-containing regimens showed impressive efficacy and tolerability in this heavily experienced cohort.


Related Articles

  • Nelfinavir: A Review of its Use in the Management of HIV Infection. Perry, Caroline M.; Frampton, James E.; McCormack, Paul L.; Siddiqui, M. Asif A.; Cvetkovi0107;, Risto S. // Drugs;2005, Vol. 65 Issue 15, p2209 

    Nelfinavir (Viracept®) is an orally administered protease inhibitor. In combination with other antiretroviral drugs (usually nucleoside reverse transcriptase inhibitors [NRTIs]), nelfinavir produces substantial and sustained reductions in viral load in patients with HIV infection. Nelfinavir...

  • Initiating Highly Active Antiretroviral Therapy with Newer Protease Inhibitors Is Associated with Better Survival Compared to First-Generation Protease Inhibitors or Nevirapine. Crane, Heidi M.; Van Rompaey, Stephen E.; Kitahata, Mari M. // AIDS Patient Care & STDs;Dec2007, Vol. 21 Issue 12, p920 

    The high prevalence of comorbidity among HIV-infected patients in care such as hepatitis C virus (HCV) coinfection and mental illness may contribute to increased toxicity and decreased adherence to highly active antiretroviral therapy (HAART). Newer HAART regimens have less toxicity and better...

  • Body Fat and Other Metabolic Effects of Atazanavir and Efavirenz, Each Administered in Combination with Zidovudine plus Lamivudine, in Antiretroviral- Naive HIV- Infected Patients. Jemsek, Joseph G.; Arathoon, Eduardo; Arlotti, Massimo; Perez, Carlos; Sosa, Nestor; Pokrovskiy, Vadim; Thiry, Alexandra; Soccodato, Michael; Noor, Mustafa A.; Giordano, Michael // Clinical Infectious Diseases;1/15/2006, Vol. 42 Issue 2, p273 

    Background. Protease inhibitor treatment of human immunodeficiency virus (HIV)-infected individuals has been linked to the development of lipodystrophy. The effects of atazanavir on body fat distribution and related metabolic parameters were examined in antiretroviral-naive patients. Methods....

  • Efficacy of short-term monotherapy with maraviroc, a new CCR5 antagonist, in patients infected with HIV-1. F&ätkenheuer, Gerd; Pozniak, Anton L.; Johnson, Margaret A.; Plettenberg, Andreas; Staszewski, Schlomo; Hoepelman, Andy I. M.; Saag, Michael S.; Goebel, Frank D.; Rockstroh, Jürgen K.; Dezube, Bruce J.; Jenkins, Tim M.; Medhurst, Christine; Sullivan, John F.; Ridgway, Caroline; Abel, Samantha; James, Ian T.; Youle, Mike; van der Ryst, Elna // Nature Medicine;Nov2005, Vol. 11 Issue 11, p1170 

    We assessed the efficacy and safety of 10-d monotherapy with the orally administered CCR5 antagonist maraviroc in 63 HIV-1-positive individuals prescreened for the absence of CXCR4-using virus. Maximum reduction in viral load occurred at a median of 10–15 d, with a mean reduction of...

  • Lead Optimisation: Improving the Affinity of the Antiretrovirals Nelfinavir and Amprenavir for HIV-1 Protease. Fernandes, P. A.; Ara�jo, M.L. A.C.; Barbosa, A. J.M.; Alves, C. N.; Ferreira, Z. Q.; R.-N. Gonzalez, C.; C. Lima, C.F. R.A.; Loureiro, S. I.E.; Magalhaes, J. M.T.; Maia, F. C.; Moura, S. A.; Peredo, E.M. M.; Perez, M.A. S.; Rodrigues, T.A. Q.; Pessoa, A.M.; da Silva, C.A. M.; da Silva, J.P. A.; Ramos, M. J. // Letters in Drug Design & Discovery;Aug2006, Vol. 3 Issue 6, p383 

    Nelfinavir (Viracept�, Pfizer), and Amprenavir (Ageneraze�, GlaxoSmithKline) are potent bioavailable inhibitors of the enzyme Protease (PR) of the Human Immunodeficiency V�rus-1 (HIV-1), which have been developed by consistent structure-based drug design projects, and have been...

  • Rate of Viral Evolution and Risk of Losing Future Drug Options in Heavily Pretreated, HIV-Infected Patients Who Continue to Receive a Stable, Partially Suppressive Treatment Regimen. Hatano, Hiroyu; Hunt, Peter; Weidler, Jodi; Coakley, Eoin; Hoh, Rebecca; Liegler, Teri; Martin, Jeffrey N.; Deeks, Steven G. // Clinical Infectious Diseases;11/15/2006, Vol. 43 Issue 10, p1329 

    Background. Many treatment-experienced, HIV-infected patients who have limited therapeutic options for complete viral suppression continue to receive a partially suppressive treatment regimen pending the availability of at least 2 new antiretroviral drugs. The major risk of this approach is...

  • Effects of HIV Antiretroviral Therapy on Sexual and Injecting Risk-Taking Behavior: A Systematic Review and Meta-analysis. Doyle, Joseph S.; Degenhardt, Louisa; Pedrana, Alisa E.; McBryde, Emma S.; Guy, Rebecca J.; Stoové, Mark A.; Weaver, Emma R.; Grulich, Andrew E.; Lo, Ying-Ru; Hellard, Margaret E. // Clinical Infectious Diseases;Nov2014, Vol. 59 Issue 10, p1483 

    This systematic review and meta-analysis of 58 studies found that antiretroviral therapy is not associated with increased sexual or injecting risk-taking behavior among HIV-infected individuals undergoing treatment.Background. Increased global access and use of antiretroviral therapy (ART) for...

  • Boosted Darunavir for Treatment-Experienced Patients.  // Clinical Infectious Diseases;9/1/2007, Vol. 45 Issue 5, pvi 

    The article discusses the study "Efficacy and safety of darunavir-ritonavir at week 48 in treatment-experienced patients with HIV-1 infection in POWER 1 and 2: a pooled subgroup analysis of data from two randomized trials," by B. Clotet and colleagues. In the study, the researchers gave the...

  • Decreasing HIV Drug Resistance in the United Kingdom.  // Clinical Infectious Diseases;9/1/2007, Vol. 45 Issue 5, pvi 

    The article discusses the study "A decreasing prevalence of antiretroviral drug resistance in the UK: evidence of a decline in transmitted HIV-1 drug resistance in the United Kingdom." In the study, the researchers conducted analysis of major resistance mutations to determine time-dependent...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics