Positive virological outcome after lopinavir/ritonavir salvage therapy in protease inhibitor-experienced HIV-1-infected children: a prospective cohort study
| Autor: | Ma Isabel De José, José Ma Bellón, Dolores Gurbindo, Milagros González-Rivera, Ma Isabel González, Esther Cabrero, Salvador Resino, José Tomás Ramos, Mellado Mj, Ma Angeles Muñoz-Fernández |
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| Rok vydání: | 2004 |
| Předmět: |
Microbiology (medical)
Oncology medicine.medical_specialty Lopinavir/ritonavir Salvage therapy Pyrimidinones Lopinavir Cohort Studies Pharmacotherapy immune system diseases Internal medicine Antiretroviral Therapy Highly Active medicine Humans Pharmacology (medical) Protease inhibitor (pharmacology) Prospective Studies Pharmacology Salvage Therapy Acquired Immunodeficiency Syndrome Ritonavir business.industry Proteolytic enzymes virus diseases CD4 Lymphocyte Count Regimen Infectious Diseases Immunology HIV-1 Drug Therapy Combination business medicine.drug |
| Zdroj: | The Journal of antimicrobial chemotherapy. 54(5) |
| ISSN: | 0305-7453 |
| Popis: | Lopinavir/ritonavir has demonstrated antiviral activity in the HIV-infected patient.To analyse virological response to lopinavir/ritonavir therapy in previously protease inhibitor (PI)-experienced HIV-1-infected children.Sixty-seven HIV-1-children on lopinavir/ritonavir were studied in a multicentre prospective cohort observational study. The outcome variables were undetectable viral load (uVL; VLor =400 copies/mL) and virological failure after uVL with a rebound of VL400 copies/mL. VL and genotype of HIV-1-isolates were measured using standard assays.83.5% of children had a 1 log10 VL decrease including 65.6% who reached uVL. Children with2 changes of antiretroviral therapy (ART) or5 drugs needed a median time of 3-4 months higher than children withor =2 changes of ART oror =5 drugs previous to lopinavir/ritonavir, to reach those values, and the relative proportions (RP) were 2.2 (P =0.038) and 1.9 (P=0.050), respectively. Children with CD4+15% (P=0.122), VLor =30,000 (P0.001) copies/mL, and age12 years (P=0.096) achieved an earlier control of VL during the follow-up. The children with virological failure or rebound of VL had higher baseline VL and lower CD4+ T-lymphocytes/mm3 and had taken a greater number of drugs previous to lopinavir/ritonavir. HIV-children with a new nucleoside reverse transcriptase inhibitor (NRTI), or protease inhibitor (PI) or PI plus non-nucleoside reverse transcriptase inhibitors (NNRTI) in the current regimen had a better virological response than children without these new drugs. Also, children with6 protease mutations had an RP of 2.31 of achieving uVL.Highly active antiretroviral therapy (HAART) including lopinavir/ritonavir induces beneficial effects in terms of virological outcome responses, and it is an effective option for salvage therapy in PI-experienced HIV-1-infected children. |
| Databáze: | OpenAIRE |
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