title: Case series assessing the safety of mycophenolate as part of multidrug rescue treatment regimens.
abstract: BACKGROUND
  Mycophenolate mofetil (MMF), an inhibitor of lymphocyte proliferation, is emerging as a potential adjunct in the treatment of HIV-1 infection. By potentiating the activity of abacavir, MMF may improve antiviral efficacy. However, it may also lead to myelosuppression, such as was seen in patients taking hydroxyurea-containing regimens.
  
  
  OBJECTIVE
  To assess the safety of MMF as adjunctive therapy for HIV infection.
  
  
  METHODS
  Eighteen HIV-positive outpatients, given MMF (500 mg po bid) on a compassionate basis as part of their salvage therapy, were monitored for adverse effects.
  
  
  RESULTS
  Five patients discontinued MMF between 26-68 days of follow-up due to adverse effects likely related to other factors. Among the remaining 13 patients, no new clinically significant cytopenias occurred over 107-154 days of follow-up. Three patients exhibited decreases in CD4 counts, despite decreases in plasma HIV-1 RNA.
  
  
  CONCLUSIONS
  Short-term follow-up suggests that MMF (500 mg po bid) does not cause lymphocyte suppression. However, further studies are ongoing to determine its safety and efficacy profile in HIV infection.
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital and Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. npress@hivnet.ubc.ca
authors.forename: Natasha
authors.initials: N
authors.lastname: Press
authors.forename: Gil
authors.initials: G
authors.lastname: Kimel
authors.forename: Marianne
authors.initials: M
authors.lastname: Harris
authors.forename: Benita
authors.initials: B
authors.lastname: Yip
authors.forename: Kevin J P
authors.initials: KJ
authors.lastname: Craib
authors.forename: Julio S G
authors.initials: JS
authors.lastname: Montaner
mesh_terms: D000284:Administration, Oral; D000328:Adult; D015496:CD4-Positive T-Lymphocytes; D024882:Drug Resistance, Viral; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1 / Q000235:genetics*; D006801:Humans; D007168:IMP Dehydrogenase / Q000037:antagonists & inhibitors*; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use*; D012367:RNA, Viral / Q000097:blood*; D016879:Salvage Therapy; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D007166:Immunosuppressive Agents; D012367:RNA, Viral; D007168:IMP Dehydrogenase; D009173:Mycophenolic Acid