title: Factors associated with virological response to etravirine in nonnucleoside reverse transcriptase inhibitor-experienced HIV-1-infected patients.
abstract: To identify factors associated with virological response (VR) to an etravirine (ETR)-based regimen, 243 patients previously treated with nonnucleoside reverse transcriptase inhibitors (NNRTIs) were studied. The impact of baseline HIV-1 RNA, CD4 cell count, past NNRTIs used, 57 NNRTI resistance mutations, genotypic sensitivity score (GSS) for nucleoside reverse transcriptase inhibitors (NRTIs) and protease inhibitors (PIs), and the number of new drugs used with ETR for the first time on the VR to an ETR regimen were investigated. Among the 243 patients, the median baseline HIV-1 RNA level was 4.4 log(10) copies/ml (interquartile range [IQR], 3.7 to 4.9) and the median CD4 count was 175 cells/mm(3) (IQR, 69 to 312). Patients had been previously exposed to a median of 6 NRTIs, 1, NNRTI, and 5 PIs. Overall, 82% of patients achieved a VR at month 2, as defined by a decrease of at least 1.5 log(10) copies/ml and/or HIV-1 RNA level of <50 copies/ml. No difference in VR was observed between patients receiving or not a boosted PI in combination with ETR. Factors independently associated with a better VR to ETR were the number of drugs (among enfuvirtide, darunavir, or raltegravir) used for the first time in combination with ETR and the presence of the K103N mutation at baseline. Mutations Y181V and E138A were independently associated with poor VR, whereas no effect of the Y181C on VR was observed. In conclusion, ETR was associated with high response rates in NNRTI-experienced patients in combination with other active drugs regardless of the therapeutic class used.
authors.affiliation: Department of Virology, Pitié-Salpêtrière Hospital, 83 Boulevard de l'Hôpital, 75013 Paris, France. anne-genevieve.marcelin@psl.aphp.fr
authors.forename: Anne-Genevieve
authors.initials: AG
authors.lastname: Marcelin
authors.forename: Philippe
authors.initials: P
authors.lastname: Flandre
authors.forename: Diane
authors.initials: D
authors.lastname: Descamps
authors.forename: Laurence
authors.initials: L
authors.lastname: Morand-Joubert
authors.forename: Charlotte
authors.initials: C
authors.lastname: Charpentier
authors.forename: Jacques
authors.initials: J
authors.lastname: Izopet
authors.forename: Mary-Anne
authors.initials: MA
authors.lastname: Trabaud
authors.forename: Henia
authors.initials: H
authors.lastname: Saoudin
authors.forename: Constance
authors.initials: C
authors.lastname: Delaugerre
authors.forename: Catherine
authors.initials: C
authors.lastname: Tamalet
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Cottalorda
authors.forename: Magali
authors.initials: M
authors.lastname: Bouvier-Alias
authors.forename: Dominique
authors.initials: D
authors.lastname: Bettinger
authors.forename: Georges
authors.initials: G
authors.lastname: Dos Santos
authors.forename: Annick
authors.initials: A
authors.lastname: Ruffault
authors.forename: Chakib
authors.initials: C
authors.lastname: Alloui
authors.forename: Cecile
authors.initials: C
authors.lastname: Henquell
authors.forename: Sylvie
authors.initials: S
authors.lastname: Rogez
authors.forename: Francis
authors.initials: F
authors.lastname: Barin
authors.forename: Anne
authors.initials: A
authors.lastname: Signori-Schmuck
authors.forename: Sophie
authors.initials: S
authors.lastname: Vallet
authors.forename: Bernard
authors.initials: B
authors.lastname: Masquelier
authors.forename: Vincent
authors.initials: V
authors.lastname: Calvez
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D024882:Drug Resistance, Viral / Q000235:genetics; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology*; D054303:HIV Reverse Transcriptase / Q000235:genetics; D015497:HIV-1 / Q000187:drug effects / Q000235:genetics; D006801:Humans; D008297:Male; D009154:Mutation; D009570:Nitriles; D010802:Phylogeny; D011724:Pyridazines / Q000627:therapeutic use*; D011743:Pyrimidines; D012367:RNA, Viral / Q000096:biosynthesis / Q000235:genetics; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D016896:Treatment Outcome
chemical_list: D019380:Anti-HIV Agents; D009570:Nitriles; D011724:Pyridazines; D011743:Pyrimidines; D012367:RNA, Viral; D018894:Reverse Transcriptase Inhibitors; C451734:etravirine; D054303:HIV Reverse Transcriptase