Combivir Plus PI Kaletra HIV Prophylaxis May Increase Tolerability

By David Douglas

HIV post-exposure prophylaxis (PEP) with zidovudine/lamivudine (Combivir, GlaxoSmithKline) along with lopinavir-ritonavir (Kaletra, Abbot) may be more easily tolerated than other multidrug regimens, French researchers report in the January 15th issue of Clinical Infectious Diseases.

In France, current PEP guidelines recommend the use of a three-drug combination for 4 weeks. However, lead investigator Dr. Christian Rabaud told Reuters Health, "the few available data indicate that significant adverse events occur in more than two-thirds of otherwise healthy persons who receive a multidrug PEP regimen. Better-tolerated PEP combinations must, therefore, be sought."

As part of that effort, Dr. Rabaud of Centre d'Information et de Soins sur l'Immunodeficience Humaine, Lorraine Champagne-Ardenne, and colleagues studied prospectively collected data on 121 patients who were given PEP consisting of Combivir and Kaletra.

A total of 23 patients discontinued PEP for reasons other than adverse effects. Overall, 59% of the remaining patients experienced adverse events. However, these led to PEP discontinuation in only 20%.

Thus, continued Dr. Rabaud, this combination is better tolerated than the previously used Combivir plus nelfinavir (Viracept) or Combivir plus indinavir (Crixivan) regimens.

"In conclusion," he said, "we suggest that the Combivir plus Kaletra combination should now be preferred... for post-exposure prophylaxis."

02/04/05

Clin Infect Dis 2005;40:303-305.

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