Cabie A, Lamotte C, Dos Santos G, Pay SM, Abel S, Ouka M, Cesaire R, Liautaud B, Peytavin G; International Conference on AIDS (15th : 2004 : Bangkok, Thailand).

Int Conf AIDS. 2004 Jul 11-16; 15: abstract no. TuPeB4620.

Maladies Infectieuses et Tropicales, CHU de Fort-de-France, Fort-de-France, Martinique

Background: to combine virological and pharmacological parameters in a genotypic inhibitory quotient (GIQ) to predict the virological response to LPV/r. Methods: 74 protease inhibitor (PI)-experienced patients treated with LPV/r (400/100 mg bid) containing regimen were enrolled in an observational prospective cohort. Baseline (D0) genotype, Plasma HIV-RNA (VL) and CD4 cell count were available at D0, M1, M3 and every 3 months. Virological response was defined as VL<50 cp/mL at M6. Plasma LPV Cmin were determined systematically at W2 and at the time of virological failure or adverse effects to adjust LPV Cmin (12 hrs after the last intake) in the adequate range of 3,000-7,000 ng/mL. Protease mutations from positions 10,20,24,33,36,47,48,54,82,84 were chosen, according to the french ANRS-AC11 algorithm. The GIQ was defined as the ratio of LPV Cmin to the number of specific LPV mutations. Results: At D0, Median VL was 5.0 log10 cp/mL, 109 CD4/muL, 3 lines (range 1-6) of prior HAART, and 3 PI mutations (range 1-8). Before and after TDM at W2, mean (+/- SD) LPV Cmin were adequate in 36% vs 64%, >7,000 ng/mL in 32% vs 21% and< 3,000 ng/mL in 32% vs 15% (p=0.007, n = 188). Mean (+/- SD) GIQ calculated in responders (58%) vs non responders (42%) were significantly higher: 4330 +/- 4344 vs 1780 +/- 2619 (p< 0.001) (Mann-Whitney test). A GIQ value above the median cut-off of 2133 was significantly associated with a relative risk (IC95%) of 2.54 (1.33-4.85) to reach a VL<50 cp/mL at M6. Conclusions: Early TDM and median GIQ >2133 were useful predictors of virological response to LPV/r containing regimen in Caribbean patients with substantial PI resistance at M6.

Publication Types:

• Meeting Abstracts

Keywords:

• AIDS Vaccines
• Acquired Immunodeficiency Syndrome
• Antiretroviral Therapy, Highly Active
• CD4 Lymphocyte Count
• Caribbean Region
• Drug Monitoring
• Drug Therapy, Combination
• HIV Infections
• HIV Seropositivity
• Humans
• Longitudinal Studies
• Pyrimidinones
• Ritonavir
• Salvage Therapy
• drug therapy
• lopinavir
• therapy

Other ID:

• GWAIDS0038226

UI: 102282442

From Meeting Abstracts