Results of Salvage Therapy with Ritonavir-boosted Amprenavir and
Ritonavir-boosted Fosamprenavir
The aim of the current study was to evaluate the efficacy of salvage regimens
containing ritonavir-boosted
amprenavir (APV/r) or fosamprenavir
(FPV/r) in heavily pretreated protease inhibitor
(PI)-experienced HIV-1 patients.
The
study was designed to evaluate APV/r- or FPV/r-containing antiretroviral
regimens in PI-experienced HIV-1 patients with 2 or more antiretroviral
failures. Follow-up continued to 96 weeks with prospective collection
of data.
Results
54 episodes (48 on APV/r
and 6 on FPV/r) were considered in 45 patients who had received
a median of 5 prior antiretroviral regimens, including a median
of 3 PIs.
Median time of treatment
at analysis was 72 weeks.
At baseline, plasma viral
load (pVL) and CD4 cell count was 67,000 copies/mL and 167 cell/mm(3), respectively.
At week 96, the median pVL
was < 50 copies/mL and CD4 cell count was 519 cells/mm(3).
Proportion of patients with
pVL below detection
was 62% at week 48 and 61% at week 96.
Fifteen patients stopped
treatment because of virologic
failure; one presented a full resistance profile
to APV/r, based on the ANRS 2003 resistance algorithm.
Median trough APV plasma concentration 4 weeks after treatment
initiation was 1406 ng/mL (range, 452-4321); dose adaptation was
required in only 7 patients.
The
authors conclude, “This study provides long-term follow-up of
APV/r and FPV/r in the setting of salvage therapy, showing a high
and sustained rate of virologic and immunologic response.”
10/12/05
Reference
R
Quercia and others. Salvage therapy with ritonavir-boosted
amprenavir/fosamprenavir: virological and immunological response
in two years follow-up. HIV Clinical Trials 6(2):73-80.
March-April 2005.
