Tenofovir DF in antiretroviral-experienced patients: results from a 48-week, randomized, double-blind study.
OBJECTIVE
To evaluate the safety and efficacy of once daily doses of tenofovir DF (TDF) administered in combination with other antiretroviral therapy (ART) in treatment-experienced HIV-1-infected patients with incomplete virological suppression.


METHODS
One-hundred and eighty-nine subjects with plasma HIV-1 RNA levels between 400 and 100,000 copies/ml and stable ART (> or = 8 weeks) were randomized (2 : 2 : 2 : 1 ratio) to add TDF 75 mg, 150 mg, or 300 mg or placebo to existing ART in a double-blinded manner. After 24 weeks, patients initially randomized to placebo received blinded TDF 300 mg.


METHODS
Efficacy was analyzed by the mean changes HIV-1 RNA levels (log10 copies/ml plasma; DAVG(xx)) from week 0 to weeks 4, 24, and 48. Safety was analyzed by incidence of grade 3 or 4 clinical and laboratory adverse events.


RESULTS
At baseline, patients had mean 4.6 years prior ART use with 94% having HIV-1 with nucleoside-associated resistance mutations. There were statistically significant decreases in DAVG(4) and DAVG(24) for all doses of TDF compared with placebo, with the greatest effect seen with TDF 300 mg (DAVG(4), -0.62, P < 0.001; DAVG(24), -0.58; P < 0.001; DAVG(48), -0.62). The incidence of adverse events was similar among the TDF groups and placebo through week 24. Throughout the 48-week study, no significant changes in renal function were observed.


CONCLUSIONS
In treatment-experienced patients with baseline nucleoside resistance mutations, TDF provided dose-related, durable reductions in HIV-1 RNA. Through 24 weeks, the safety profile of TDF was similar to that of placebo.
Schooley
Robert T
RT
University of Colorado, Denver, Colorado, USA.
Ruane
Peter
P
Myers
Robert A
RA
Beall
Gildon
G
Lampiris
Harry
H
Berger
Daniel
D
Chen
Shan-Shan
SS
Miller
Michael D
MD
Isaacson
Erica
E
Cheng
Andrew K
AK
D000225:Adenine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology* / Q000627:therapeutic use*; D000328:Adult; D018791:CD4 Lymphocyte Count; D004311:Double-Blind Method; D024882:Drug Resistance, Viral; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000821:virology*; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics / Q000276:immunology / Q000502:physiology; D006801:Humans; D008297:Male; D063065:Organophosphonates; D009943:Organophosphorus Compounds / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use*; D012367:RNA, Viral / Q000032:analysis; D000068698:Tenofovir; D013997:Time Factors
D063065:Organophosphonates; D009943:Organophosphorus Compounds; D012367:RNA, Viral; D000068698:Tenofovir; D000225:Adenine