Hirschel B, Lorenzi P, Yerly S, Rutschmann O, Fahti M, Overbeck I, Iten A; Conference on Retroviruses and Opportunistic Infections.
Program Abstr 4th Conf Retrovir Oppor Infect Conf Retrovir Oppor Infect 4th 1997 Wash DC. 1997 Jan 22-26; 4th: 174 (abstract no. 594).
ID Divisions, Geneva, Switzerland. Fax: 41 22 372 98 20.
18 antiprotease-naive patients with 1 to 50 CD4 cells were treated with 600 mg of rit plus 600 mg of saq b.i.d. 1 died early from TB, 1 stopped because of [up arrow] Triglycerides and [up arrow] amylase, leaving 16 patients evaluable at 4 weeks. 11 patients responded (Rs, greater than 1 log drop in viremia at 4 weeks), whereas 5 did not (NRs). Among the 11 Rs at 4 weeks, 1 rose back to baseline at 12 weeks, and 4 stopped treatment because of side effects (1 hepatitis, 2 paresthesias) or patient choice (1). Plasma rit and saq levels were lower in Rs than in NRs (p less than 0.03). However, some NRs or transient Rs had saq levels exceeding the in vitro MIC90 by more than 50 times. The proteinase gene in NRs and transient Rs revealed multiple mutations at positions 10, 16, 36, 48, 63, 64, 82, 84, and 90 after 8 weeks of treatment, most of which were not present at time 0. In conclusion, the response to rit + saq in advanced HIV infection is unpredictable. Escape of viremia and rapid development of multiple protease mutations suggest early resistance in some patients.
Publication Types:
Keywords:
- CD4-Positive T-Lymphocytes
- Endopeptidases
- HIV Infections
- Humans
- In Vitro
- Mutation
- Ritonavir
- Saquinavir
- Viremia
- genetics
Other ID:
UI: 102223545
From Meeting Abstracts