Relationship between levels of indinavir in hair and virologic response to highly active antiretroviral therapy.
BACKGROUND
Suboptimal levels of antiretroviral drugs result in virologic failure in HIV-infected patients treated with highly active antiretroviral therapy (HAART).


OBJECTIVE
To assess the relationship between levels of indinavir in hair and virologic outcome.


METHODS
Cross-sectional study.


METHODS
7 AIDS clinics in France.


METHODS
89 HIV-infected patients who received HAART that included indinavir.


METHODS
Patients were classified as responders or nonresponders on the basis of viremia at the time of hair collection. In nonresponders, levels of indinavir in hair and resistance mutations in the protease gene were assessed at baseline and at the time of indinavir measurement.


RESULTS
Mean indinavir levels (+/-SD) were significantly higher in the 65 responders than in the 24 nonresponders (24.4 +/- 16 microg/g vs. 12.9 +/- 8.6 microg/g) (P < 0.001). Nonresponders with intermediate levels of indinavir in hair had more mutations in the protease gene than did nonresponders with low levels of indinavir in hair.


CONCLUSIONS
Indinavir levels in hair are associated with virologic outcome in patients receiving HAART.
Bernard
Louis
L
Division of Infectious Diseases, Geneva University Hospital and Laboratoire de Virologie, Rue Micheli-du-Crest, CH 1211 Geneva, Switzerland. louis.bernard@hcuge.ch
Vuagnat
Albert
A
Peytavin
Gilles
G
Hallouin
Marie-Charlotte
MC
Bouhour
Damien
D
Nguyen
Thu Huyen
TH
Vildé
Jean Louis
JL
Bricaire
François
F
Raguin
Gilles
G
de Truchis
Pierre
P
Ghez
David
D
Duong
Michel
M
Perronne
Christian
C
D000042:Absorption; D023241:Antiretroviral Therapy, Highly Active; D003430:Cross-Sectional Studies; D024882:Drug Resistance, Viral; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology*; D017320:HIV Protease Inhibitors / Q000032:analysis* / Q000627:therapeutic use; D015497:HIV-1 / Q000187:drug effects / Q000235:genetics; D006197:Hair / Q000737:chemistry* / Q000378:metabolism; D006801:Humans; D019469:Indinavir / Q000032:analysis* / Q000493:pharmacokinetics / Q000627:therapeutic use; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D010349:Patient Compliance; D012367:RNA, Viral / Q000097:blood; D012372:ROC Curve; D019562:Viral Load
D017320:HIV Protease Inhibitors; D012367:RNA, Viral; D019469:Indinavir