Predictive value of provirus load and DNA human immunodeficiency virus genotype for successful abacavir-based simplified therapy.
Of 75 human immunodeficiency virus (HIV) type 1-infected patients successfully responding to 2 nucleoside reverse-transcriptase inhibitors (NRTIs) plus 1 protease inhibitor (PI), 55 started a simplified abacavir (ABC)-based triple NRTI regimen. Influences of DNA load and DNA reverse-transcriptase (RT) mutations on virological responses were assessed at month 6 after initiation of therapy. Baseline heterogeneity was observed: peripheral blood mononuclear cell (PBMC) genotyping showed 31% RT mutations with 1-5 NRTI-related mutations, 78% protease mutations had 1-5 PI-related mutations; and HIV-1-DNA levels were 1.8-3.5 log(10) copies/10(6) PBMC. Outcomes for 49 patients on a regimen of 2 NRTIs plus ABC were as follows: 22 successes, 10 blips ("blip" defined as intermittent plasma HIV-1 RNA levels between 50 and 100 copies/mL and a return to an undetectable level), and 17 failures, whereas, for patients continuing on a regimen of 2 NRTIs plus 1 PI, there were 19 successes and 1 blip. Previous treatment regimens, baseline provirus level, and PBMC genotype predicted virological outcome.
Pellegrin
Isabelle
I
Department of Virology, Bordeaux University Hospital, France. isabelle.pellegrin@chu-bordeaux.fr
Caumont
Anne
A
Garrigue
Isabelle
I
Merel
Patrick
P
Schrive
Marie-Hélène
MH
Fleury
Hervé
H
Dupon
Michel
M
Pellegrin
Jean-Luc
JL
Ragnaud
Jean-Marie
JM
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000821:virology; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D004279:DNA, Viral / Q000032:analysis*; D015224:Dideoxynucleosides / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D005838:Genotype; D017320:HIV Protease Inhibitors / Q000008:administration & dosage; D054303:HIV Reverse Transcriptase / Q000235:genetics*; D015497:HIV-1 / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D012367:RNA, Viral / Q000097:blood; D019562:Viral Load; D000099227:Abacavir
D004279:DNA, Viral; D015224:Dideoxynucleosides; D017320:HIV Protease Inhibitors; D054303:HIV Reverse Transcriptase; D012367:RNA, Viral; D000099227:Abacavir