Low initial trough plasma concentrations of lopinavir are associated with an impairment of virological response in an unselected cohort of HIV-1-infected patients.
OBJECTIVE
The relationship between lopinavir trough plasma concentration at baseline and virological efficacy 3 months after the beginning of the therapy was investigated in an unselected cohort of HIV-1-infected patients


METHODS
According to initial trough lopinavir plasma level, patients were classified into three groups: the subtherapeutic group (<3 mg/L, n=18), the therapeutic group (between 3 and 8 mg/L, n=50) and the toxic group (>8 mg/L, n=16). The virological response after 3 months of lopinavir treatment, defined as a viral load <200 HIV-1 RNA copies/mL, was compared amongst these groups.


RESULTS
The virological response was significantly different (P<0.05) between the subtherapeutic group (22.% of patients with viral load<200 copies/mL) and the other groups (56.0% of patients with a viral load<200 copies/mL in the therapeutic group and 56.2% in the toxic group).


CONCLUSIONS
A lower virological efficacy should be expected for experienced or naive patients with plasma trough lopinavir concentrations<3 mg/L at the beginning of treatment.
Department of Infectious Diseases, Hôtel Dieu, Nantes, France.
M I
MI
Wateba
E
E
Billaud
E
E
Dailly
P
P
Jolliet
F
F
Raffi
D000328:Adult; D016009:Chi-Square Distribution; D004334:Drug Administration Schedule; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000188:drug therapy; D017320:HIV Protease Inhibitors / Q000097:blood* / Q000627:therapeutic use*; D015497:HIV-1; D006801:Humans; D061466:Lopinavir; D008297:Male; D008875:Middle Aged; D011744:Pyrimidinones / Q000097:blood* / Q000627:therapeutic use*; D012189:Retrospective Studies; D019438:Ritonavir / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load
D017320:HIV Protease Inhibitors; D011744:Pyrimidinones; D061466:Lopinavir; D019438:Ritonavir