[Lopinavir/ritonavir in HIV-infected patient with long-term virological failure: immunovirological response and tolerance in 121 patients of the ANRS CO8 Aproco-Copilote cohort].
OBJECTIVE
This study was made to determine the immunovirological outcome and tolerance to lopinavir/ritonavir (LPV/r) in HIV-infected protease inhibitors-experienced patients with long-term virological failure.


METHODS
Prospective follow-up was implemented for the French cohort ANRS CO8 Aproco-Copilote of 121 patients starting an LPV/r-containing regimen after a median duration of virological failure of 30.6 months. At baseline the median HIV-RNA plasma level was 4.1 log(10) copies/ml and the median CD4 cell count was 273/mm(3).


RESULTS
On initiation of LPV/r, these patients were heavily pre-treated: 62% had received at least 4 NRTI, 65% at least 1 NNRTI, and 33% at least 3 PI. On prescription of LPV/r, the associated antiretroviral regimen was: no drug to which patients were previously naïve in 49 cases (40%), at least one new drug in 72 cases: 1 NRTI (n=42), 2 NRTI (n=22), 1 NNRTI (n=10), at least one new PI (n=6), enfuvirtide (n=2). The median HIV-RNA level was 2 log(10) copies/ml at M4 and M12, 1.7 log(10) copies/ml at M24 with respectively 74, 71 and 85% of patients achieving plasma HIV-RNA below 2.7 log(10) copies/ml. The median CD4 cell count was 385 and 429/mm(3) at M12 and M24 respectively. Among patients with genotypic testing at the time of LPV/r initiation, Ninety-five percent had at the most 5 protease mutations known to reduce LPV/r susceptibility. Thirty serious adverse events were reported but only 6 were related to LPV/r.


CONCLUSIONS
The use of LPV/r in HIV-infected patients failing multiple antiretroviral regimens provided a potent and durable immunovirological response.
Brunet-François
C
C
Maladies Infectieuses et Tropicales, Hôtel-Dieu, Nantes, France.
Taieb
A
A
Masquelier
B
B
Le Moing
V
V
Lewden
C
C
Dellamonica
P
P
Cuzin
L
L
Allavena
C
C
Spire
B
B
Chêne
G
G
Raffi
F
F
D019380:Anti-HIV Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D024882:Drug Resistance, Viral; D004361:Drug Tolerance; D005838:Genotype; D006678:HIV / Q000235:genetics; D015658:HIV Infections / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000627:therapeutic use*; D006801:Humans; D061466:Lopinavir; D010865:Pilot Projects; D011744:Pyrimidinones / Q000627:therapeutic use*; D019438:Ritonavir / Q000627:therapeutic use*; D017211:Treatment Failure
D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors; D011744:Pyrimidinones; D061466:Lopinavir; D019438:Ritonavir