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Titolo:
Shift in HIV resistance genotype after treatment interruption and short-term antiviral effect following a new salvage regimen
Autore:
Izopet, J; Massip, P; Souyris, C; Sandres, K; Puissant, B; Obadia, M; Pasquier, C; Bonnet, E; Marchou, B; Puel, J;
Indirizzi:
Hop Purpan, Virol Lab, F-31059 Toulouse, France Hop Purpan Toulouse France F-31059 , Virol Lab, F-31059 Toulouse, France CHU Toulouse, Hop Purpan, Virol Lab, Toulouse, France CHU Toulouse Toulouse France e, Hop Purpan, Virol Lab, Toulouse, France CHU Toulouse, Hop Purpan, Serv Malad Infect, Toulouse, France CHU Toulouse Toulouse France urpan, Serv Malad Infect, Toulouse, France
Titolo Testata:
AIDS
fascicolo: 15, volume: 14, anno: 2000,
pagine: 2247 - 2255
SICI:
0269-9370(20001020)14:15<2247:SIHRGA>2.0.ZU;2-P
Fonte:
ISI
Lingua:
ENG
Soggetto:
IMMUNODEFICIENCY-VIRUS TYPE-1; PROTEASE INHIBITOR THERAPY; ACTIVE ANTIRETROVIRAL THERAPY; REVERSE-TRANSCRIPTASE; IN-VIVO; REPLICATIVE FITNESS; TREATMENT FAILURE; DISCONTINUATION; DIDANOSINE; INFECTION;
Keywords:
HIV drug resistance; treatment interruption; salvage therapy; protease inhibitors; reverse transcriptase inhibitors; antiretroviral therapy;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
38
Recensione:
Indirizzi per estratti:
Indirizzo: Izopet, J Hop Purpan, Virol Lab, Pl Docteur Baylac, F-31059 Toulouse, France Hop Purpan Pl Docteur Baylac Toulouse France F-31059 se, France
Citazione:
J. Izopet et al., "Shift in HIV resistance genotype after treatment interruption and short-term antiviral effect following a new salvage regimen", AIDS, 14(15), 2000, pp. 2247-2255

Abstract

Objective: To investigate the changes in genotypic drug-resistance pattern, plasma HIV RNA and CD4 cell count after treatment interruption and assessthe short-term antiviral effect of a new salvage regimen. Design: Prospective study of 38 patients with multiple failing regimens who had completely stopped all medication for 3 months before a three to five-drug regimen was reintroduced according to clinical guidelines. Methods: Patients were tested for HIV resistance before and after treatment interruption by population-based sequencing and clonal analysis of selected patients. Results: Discontinuation of therapy for 3 months was associated with a median increase in HIV RNA of 0.4 log(10) and a median decrease in CD4 cell count of 43 x 10(6)/l. Sixty-one per cent of patients had a shift from the drug-resistant genotype to a predominantly wild-type genotype. The patients significantly likely to show genotype reversion were those in Centers for Disease Control groups A or B, who had been exposed to few drugs, had a low plasma HIV RNA, or a high CD4 cell count. The only independent factor predicting genotype reversion was the clinical stage. The median change in plasmaHIV RNA at month 3 after treatment reintroduction was -2.3 log(10) copies/ml in patients who had genotype reversion compared with -0.6 log(10) copies/ml in patients without genotype reversion (P = 0.004). Conclusion: Suspending treatment for 3 months after multiple failures could be a suitable strategy for optimizing salvage therapy provided it is instituted early, before the HIV disease becomes too advanced. (C) 2000 Lippincott Williams & Wilkins.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/11/20 alle ore 04:01:53