Use of Different Inhibitory Quotients To Predict Early Virological Response to Tipranavir in Antiretroviral-Experienced Human Immunodeficiency Virus-Infected Patients
| Autor: | Sonia Rodriguez-Novoa, Juan González-Lahoz, Carmen de Mendoza, Gema González-Pardo, Vincent Soriano, Francisco J. Blanco, Angélica Corral, Inmaculada Jiménez-Nácher, Lourdes Anta, Judit Morello |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Adult
Male Oncology medicine.medical_specialty Anti-HIV Agents Pyridines Human immunodeficiency virus (HIV) HIV Infections Drug resistance Biology medicine.disease_cause Antiviral Agents Virological response Internal medicine Drug Resistance Viral medicine Humans Pharmacology (medical) Trough Concentration Sida Retrospective Studies Pharmacology Sulfonamides Middle Aged Resistance mutation biology.organism_classification Virology Infectious Diseases Pyrones Female Viral disease Tipranavir medicine.drug |
| Zdroj: | Antimicrobial Agents and Chemotherapy. 53:4153-4158 |
| ISSN: | 1098-6596 0066-4804 |
| Popis: | Information about the relationship between pharmacological parameters and an early virological response to tipranavir (TPV) is scarce. Human immunodeficiency virus (HIV)-infected patients who had received TPV as part of a salvage regimen were analyzed retrospectively. A virological response was defined as a decline in the HIV RNA level of ≥1 log unit or to C trough )/virtual change in the 50% inhibitory concentration. Three genotypic inhibitory quotients (gIQs) were calculated by using different TPV resistance mutation scores (from the International AIDS Society—USA [IAS-USA], Randomized Evaluation of Strategic Intervention in Multidrug-Resistant Patients with Tipranavir [RESIST], and Agence Nationale de Recherches sur le Sida et les Hépatites Virales [ANRS] trials). The sensitivities, specificities, positive predictive values (PPVs), negative predictive values (NPVs), and likelihood ratios for a positive result (LHR + ) and a negative result (LHR − ) [LHR + = sensitivity/(1 − specificity); LHR − = (1 − sensitivity)/specificity] were calculated. A total of 57 HIV-infected patients were analyzed. A virological response was achieved by 77% of the patients. TPV resistance mutations, TPV C trough , vIQs, and gIQs were all significantly associated with a virological response. The vIQ had the best PPV and NPV (97% and 78%, respectively). The values of the LHR + were 7.8 for vIQ, 3.4 for the RESIST gIQ, 3.3 for the IAS-USA gIQ, 3.1 for the ANRS gIQ, 2.2 for TPV C trough , and 1.3 for the IAS-USA and RESIST scores. The values of LHR − were 0 for the RESIST score, 0.07 for vIQ, 0.09 for the IAS-USA score, 0.27 for the RESIST gIQ, 0.32 for the IAS-USA gIQ, 0.37 for the ANRS gIQ, and 0.48 for TPV C trough . HIV-infected patients who initiate a salvage regimen based on TPV may benefit from baseline drug resistance testing and TPV plasma concentration determination, as vIQ is the best predictor of a virological response. |
| Databáze: | OpenAIRE |
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