title: Switch from enfuvirtide to raltegravir in virologically suppressed HIV-1 infected patients: effects on level of residual viremia and quality of life.
abstract: BACKGROUND
  Raltegravir is a potential treatment option for virologically suppressed HIV-1 infected patients on enfuvirtide with injection site reactions.
  
  
  OBJECTIVE
  To characterize safety and efficacy of an enfuvirtide to raltegravir switch including changes in T-cells, quality of life, and residual viremia.
  
  
  METHODS
  In patients with viral load <50 copies/mL and injection site reactions, enfuvirtide was switched to raltegravir without additional changes to the antiretroviral regimen. Virologic failure was defined as a viral load >1000 copies/mL or two consecutive viral load measurements between 50 and 1000 copies/mL (low-level viremia). Over the 24 week study, we compared changes in T-cells, injection site reactions, quality of life, and residual viremia, as measured through the single-copy assay which can detect plasma virus down to a single copy, using paired t-tests.
  
  
  RESULTS
  Fourteen patients with a median CD4+ T-cell count of 420 cells/microL were enrolled. After the switch, two patients experienced virologic failure due to confirmed low-level viremia. However, both patients subsequently were re-suppressed, one without any changes to his regimen. There was no change in CD4+ T-cell count. Injection site reactions resolved. However, there was little reported change in quality of life. The baseline median level of residual viremia was 6 copies/mL and did not change after the switch to raltegravir.
  
  
  CONCLUSIONS
  A switch to raltegravir in virologically suppressed patients on enfuvirtide is effective in maintaining immunologic and virologic control at 24 weeks but did not result in a change in residual viremia.
authors.affiliation: Stanford University, Division of Infectious Diseases, Palo Alto, CA 94305-5107, USA. pmgrant@stanford.edu
authors.forename: Philip M
authors.initials: PM
authors.lastname: Grant
authors.forename: Sarah
authors.initials: S
authors.lastname: Palmer
authors.forename: Eran
authors.initials: E
authors.lastname: Bendavid
authors.forename: Annie
authors.initials: A
authors.lastname: Talbot
authors.forename: Debbie C
authors.initials: DC
authors.lastname: Slamowitz
authors.forename: Pat
authors.initials: P
authors.lastname: Cain
authors.forename: Stacy S
authors.initials: SS
authors.lastname: Kobayashi
authors.forename: Maya
authors.initials: M
authors.lastname: Balamane
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Zolopa
mesh_terms: D018791:CD4 Lymphocyte Count; D000077560:Enfuvirtide; D015700:HIV Envelope Protein gp41 / Q000627:therapeutic use*; D023581:HIV Fusion Inhibitors / Q000627:therapeutic use*; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1 / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000627:therapeutic use*; D011446:Prospective Studies; D011760:Pyrrolidinones / Q000627:therapeutic use*; D011788:Quality of Life; D000068898:Raltegravir Potassium; D016896:Treatment Outcome; D019562:Viral Load; D014766:Viremia / Q000188:drug therapy*
chemical_list: D015700:HIV Envelope Protein gp41; D023581:HIV Fusion Inhibitors; D010446:Peptide Fragments; D011760:Pyrrolidinones; D000077560:Enfuvirtide; D000068898:Raltegravir Potassium