Indinavir plasma concentrations and resistance mutations in patients experiencing early virological failure.
Virological failure under protease inhibitor (PI)-based antiretroviral regimens is often not explained by the selection of resistance mutations. The role of low indinavir (IDV) plasma levels in treatment failure was assessed in 46 subjects experiencing early virological failure to a first-line IDV-containing triple combination. Overall, 69% of patients showed subtherapeutic IDV plasma levels (it was not detected at all in 75% of them). Subjects with detectable but suboptimal IDV levels developed more IDV resistance mutations. Thus, drug monitoring may be useful to assess treatment adherence and risk of drug resistance in early virological failures. This information may be crucial for choosing the most appropriate rescue intervention.
González de Requena
Daniel
D
Pharmacology Unit, Hospital Carlos III, Instituto de Salud Carlos III, 28035 Madrid, Spain.
Gallego
Oscar
O
de Mendoza
Carmen
C
Corral
Angélica
A
Jiménez-Nácher
Inmaculada
I
Soriano
Vincent
V
D019380:Anti-HIV Agents / Q000627:therapeutic use; D024882:Drug Resistance, Viral / Q000235:genetics*; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D016333:HIV Protease / Q000235:genetics; D017320:HIV Protease Inhibitors / Q000097:blood* / Q000494:pharmacology / Q000627:therapeutic use; D054303:HIV Reverse Transcriptase / Q000235:genetics; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D019469:Indinavir / Q000097:blood* / Q000494:pharmacology / Q000627:therapeutic use; D009154:Mutation; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D017211:Treatment Failure
D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors; D019469:Indinavir; D054303:HIV Reverse Transcriptase; D016333:HIV Protease