Case series assessing the safety of mycophenolate as part of multidrug rescue treatment regimens.
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.
Press
Natasha
N
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
Kimel
Gil
G
Harris
Marianne
M
Yip
Benita
B
Craib
Kevin J P
KJ
Montaner
Julio S G
JS
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
D007166:Immunosuppressive Agents; D012367:RNA, Viral; D007168:IMP Dehydrogenase; D009173:Mycophenolic Acid