title: Alternating nevirapine and zidovudine treatment of human immunodeficiency virus type 1-infected persons does not prolong nevirapine activity.
abstract: The potential use of an alternating treatment strategy with nevirapine and zidovudine in prolonging the antiretroviral effects of nevirapine was evaluated. Ten human immunodeficiency virus type 1 (HIV-1)-infected p24 antigen-positive persons who had not received prior antiretroviral therapy were treated for 9-13 weeks with an alternating regimen of 1 week of nevirapine (200 mg/day) and 3 weeks of zidovudine (600 mg/day). Serum p24 antigen levels declined during the first week of nevirapine treatment (median, 59%); however, subsequent courses of nevirapine were characterized by rising p24 antigen levels, while antigen levels remained stable or declined during zidovudine treatment. Serum beta 2-microglobulin levels and CD4+ cell counts exhibited similar responses. HIV-1 isolates obtained from 2 patients revealed 40- and 1000-fold reductions in nevirapine sensitivity after 8 weeks. These findings demonstrate that alternating treatment with zidovudine and nevirapine does not prolong the effectiveness of nevirapine and does not prevent the development of nevirapine resistance.
authors.affiliation: Department of Virology, Academic Medical Centre, University of Amsterdam, Netherlands.
authors.forename: M D
authors.initials: MD
authors.lastname: de Jong
authors.forename: M
authors.initials: M
authors.lastname: Loewenthal
authors.forename: C A
authors.initials: CA
authors.lastname: Boucher
authors.forename: I
authors.initials: I
authors.lastname: van der Ende
authors.forename: D
authors.initials: D
authors.lastname: Hall
authors.forename: P
authors.initials: P
authors.lastname: Schipper
authors.forename: A
authors.initials: A
authors.lastname: Imrie
authors.forename: H M
authors.initials: HM
authors.lastname: Weigel
authors.forename: R H
authors.initials: RH
authors.lastname: Kauffmann
authors.forename: R
authors.initials: R
authors.lastname: Koster
mesh_terms: D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination; D016655:HIV Core Protein p24 / Q000097:blood; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D019829:Nevirapine; D011725:Pyridines / Q000627:therapeutic use*; D012044:Regression Analysis; D013997:Time Factors; D015215:Zidovudine / Q000627:therapeutic use*
chemical_list: D000998:Antiviral Agents; D016655:HIV Core Protein p24; D011725:Pyridines; D015215:Zidovudine; D019829:Nevirapine