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Experimental
NRTI MIV-310 Efficiently Reduces HIV Viral Load in Patients Failing
Multiple Drug Therapy: Results from a 4-week Phase II Study
Drug
resistance is an increasing problem in the treatment
of HIV infection. MIV-310
(alovudine), an experimental nucleoside
reverse transcriptase inhibitor (NRTI), potently
inhibits the replication of highly mutated strains of HIV in vitro.
French
researchers examined the efficacy of MIV-310
in highly pre-treated patients.
In
a phase II pilot study, 15 patients failing a current antiretroviral
therapy with at least two thymidine-associated mutations (TAM) were
given MIV-310 7.5 mg once daily for 4 weeks, in addition to their
ongoing treatment.
The
primary endpoint was the plasma
viral load reduction at week 4.
Results
At
baseline, the median viral load was 3.93 log10 copies/ml and the
median CD4
cell count was 360 cells/mm3.
After
4 weeks of MIV-310 administration, the median decrease in viral
load was -1.13 log10. Interestingly, the median reduction was only
-0.57 log10 in the four patients on stavudine
(Zerit), contrasting with a median reduction of -1.88
log10 in the 11 patients not receiving concomitant stavudine.
The
viral load fell by a median of -1.60 log10 in patients with two
to three TAM
(n
= 7), and by -1.88 log10 in patients with four or five TAM (n =
8). The viral load rebounded in all patients after MIV-310 cessation.
No
mutations were found in the reverse transcriptase coding region
during MIV-310 treatment.
MIV-310
was well tolerated, with no serious
adverse events
and no treatment withdrawals.
Conclusion
MIV-310
7.5 mg/day efficiently reduced the HIV viral load in patients failing
a multiple-drug regimen. Further studies with different dosages
and longer administration times are urgently needed.
Departement
des Maladies Infectieuses et Tropicales/INSERM E0214, Hopital Pitie-Salpetriere,
Paris, France.
Summary
articles on all drugs in NRTI drug class
Articles
on experimental anti-HIV drugs
09/20/04
Reference
C
Katlama and others. MIV-310 reduces HIV viral load in patients failing multiple
antiretroviral therapy: results from a 4-week phase II study. AIDS
18(9):
1299-1304. June 18, 2004.
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