Observational study on HIV-infected subjects failing HAART receiving tenofovir plus didanosine as NRTI backbone
| Autor: | A. De Luca, Cristina Mussini, Elisabetta Chiesa, Antonella Castagna, A. Matti, Carlo Torti, C. Abeli, Nicola Gianotti, Paola Cicconi, A d'Arminio Monforte, Marco Bongiovanni, Amedeo Capetti, Mauro Zaccarelli, A. Di Biagio, Andrea Antinori, Patrizia Marconi, Valeria Tirelli, Paola Nasta, Francesca Gatti |
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| Přispěvatelé: | Bongiovanni, M., Gianotti, N., Chiesa, E., Nasta, P., Cicconi, P., Capetti, A., Di Biagio, A., Matti, A., Tirelli, V., Marconi, P., De Luca, A., Mussini, C., Gatti, F., Zaccarelli, M., Abeli, C., Torti, C., Antinori, A., Castagna, Antonella, D'arminio Monforte, A. |
| Jazyk: | angličtina |
| Rok vydání: | 2007 |
| Předmět: |
Male
Enfuvirtide Drug Resistance HIV Infections Pharmacology Gastroenterology chemistry.chemical_compound Retrospective Studie Abacavir Organophosphonate Antiretroviral Therapy Highly Active Hiv infected HIV Infection Viral Didanosine virus diseases General Medicine Middle Aged Resistance mutation Reverse Transcriptase Inhibitor AIDS Infectious Diseases Treatment Outcome Combination Reverse Transcriptase Inhibitors Drug Therapy Combination Female Sequence Analysis Human medicine.drug Microbiology (medical) Adult medicine.medical_specialty Efavirenz Adenine Anti-HIV Agents CD4 Lymphocyte Count DNA Viral Drug Resistance Viral HIV-1 Humans Mutation Organophosphonates Retrospective Studies Sequence Analysis DNA Tenofovir Antiretroviral Therapy HIV tenofovir Drug Therapy Internal medicine medicine Highly Active business.industry Anti-HIV Agent DNA chemistry Observational study business |
| Popis: | We evaluated the efficacy of tenofovir (TDF) - and didanosine (ddI)-containing backbones in HIV-infected experienced subjects. We included in the study 245 subjects who started a TDF/ddI-containing HAART with HIV-RNA > 3 log10cp/ml and an available genotypic resistance test at baseline. At baseline, median CD4 counts and HIV-RNA were 278 cell/mmc and 4.32 log10cp/ml, respectively. Seventy-four subjects (30.2%) discontinued TDF and/or ddI, 23 of them for drug-related toxicities or intolerance. One-hundred and twenty-six (51.4%) subjects achieved virologic success (HIV-RNA < 50 copies/ml in two consecutive determinations) in a median time of 6.1 months; higher HIV-RNA levels (HR: 0.66, 95% CI: 0.54- 0.79, p < 0.001 for each additional log10copies/ml), and the total number of mutations either for PI and NNRTI at baseline (HR: 0.87, 95% CI: 0.81-0.92, p < 0.001 for each additional mutation) were both predictors of virologic success. M184V was marginally associated with virologic success (HR: 1.34, 95% CI: 0.94-1.90, p = 0.10 vs no M184V), whilst the number of TAMs was not associated. One-hundred-thirty-three (54.3%) subjects achieved immunologic success (increase of ⥠100 cells/mm3from baseline) in a median time of 7.5 months; immunologic success was associated with HIV-RNA levels at baseline (HR: 0.91, 95% CI: 0.79-0.98, p = 0.04 for each additional log10copies/ml), the total number of mutations either for PI or NNRTI (HR: 0.91, 95% CI: 0.85-0.98, p = 0.01 for each additional mutation) and CD4 count at baseline (HR: 1.11, 95% CI: 1.00-1.23, p = 0.05 for each additional 100 cells/mm3). Results obtained by the on-treatment analyses were comparable. In our study, HAART containing TDF/ddI seem associated with a virologic and immunologic response, when such regimens are chosen according to a genotypic resistance test. © 2007 Urban & Vogel. |
| Databáze: | OpenAIRE |
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