title: Tipranavir in highly antiretroviral treatment-experienced patients: Results from a French prospective cohort.
abstract: BACKGROUND
  In highly antiretroviral-experienced patients with a multidrug-resistant human immunodeficiency virus (HIV) infection, recommended regimens should preferentially contain 3 active components, including a ritonavir-boosted protease inhibitor (PI/r). Tipranavir/r (TPV/r), a non-peptidic PI, has been specifically developed for patients resistant to the usual antiretroviral classes including PIs. This paper discusses the role of TPV/r in patients experiencing multiple PI resistance.
  
  
  METHODS
  Virological, immunological, and safety outcomes were collected between 2003 and 2007 at 7 clinical units. Virus resistance assessment was based on 3 different genotypic tests. The 207 patients evaluated had previously received nucleoside reverse transcriptase inhibitors (NRTIs) and PIs.
  
  
  RESULTS
  The main drugs co-administered with TPV/r were 1 or 2 NRTIs associated, in half of the patients, with enfuvirtide. After 12 weeks, viral load was <50 copies/ml in 38% of the patients (44% with enfuvirtide), while median CD4 counts had increased from 150 to 250 cells/mm³. Genotypic testing suggested that most of the patients had viruses susceptible to TPV. Lipid and transaminase levels were slightly modified, and less than 10% of treatment discontinuations were due to gastrointestinal events.
  
  
  CONCLUSIONS
  A regimen including TPV/r associated with at least 1 active component is a valuable option in highly ARV-experienced patients with multi-resistance to the usual ARV classes including PIs.
authors.affiliation: Service de Maladies Infectieuses et Tropicales, Hôtel Dieu, CHU Nantes, France. clotilde.allavena@chu-nantes.fr
authors.forename: Clotilde
authors.initials: C
authors.lastname: Allavena
authors.forename: Philippe
authors.initials: P
authors.lastname: Flandre
authors.forename: Pascal
authors.initials: P
authors.lastname: Pugliese
authors.forename: Marc-Antoine
authors.initials: MA
authors.lastname: Valantin
authors.forename: Isabelle
authors.initials: I
authors.lastname: Poizot-Martin
authors.forename: André
authors.initials: A
authors.lastname: Cabié
authors.forename: Hugues
authors.initials: H
authors.lastname: Melliez
authors.forename: Lise
authors.initials: L
authors.lastname: Cuzin
authors.forename: Claudine
authors.initials: C
authors.lastname: Duvivier
authors.forename: Pierre
authors.initials: P
authors.lastname: Dellamonica
authors.forename: François
authors.initials: F
authors.lastname: Raffi
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D024921:Drug Resistance, Multiple, Viral; D004359:Drug Therapy, Combination; D005260:Female; D005602:France; D015658:HIV Infections / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000627:therapeutic use*; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011725:Pyridines / Q000627:therapeutic use*; D011753:Pyrones / Q000627:therapeutic use*; D019438:Ritonavir / Q000627:therapeutic use; D013449:Sulfonamides; D019562:Viral Load / Q000187:drug effects*
chemical_list: D017320:HIV Protease Inhibitors; D011725:Pyridines; D011753:Pyrones; D013449:Sulfonamides; D019438:Ritonavir; C107201:tipranavir