BIOMAT Database Logo BIOMAT Database Logo

Efficacy and tolerability of a double boosted protease inhibitor (lopinavir + saquinavir/ritonavir) regimen in HIV-infected patients who failed treatment with nonnucleoside reverse transcriptase inhibitors. 2007

P Chetchotisakd, and S Anunnatsiri, and P Mootsikapun, and S Kiertiburanakul, and T Anekthananon, and C Bowonwatanuwong, and B Kowadisaiburana, and K Supparatpinyo, and K Ruxrungtham, and
Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand. ploencha@kku.ac.th

OBJECTIVE Long-term nonnucleoside reverse transcriptase inhibitor (NNRTI)-based antiretroviral treatment failure in most developing countries has led to broad cross-resistance within NNRTI and nucleoside reverse transcriptase inhibitor (NRTI) classes. In this study, we investigated the efficacy and tolerability of a double boosted protease inhibitor (PI) regimen in this setting. METHODS A total of 64 HIV-infected patients who had failed NNRTI-based regimens were randomized to receive either lopinavir/saquinavir/ritonavir [LPV/SQV/r; 400/1000/100 mg twice a day (bid)] alone or indinavir/ritonavir (IDV/r; 800/100 mg bid) plus two NRTIs optimized with genotypic drug resistance guidance. Patients who had no available optimized NRTI backbone were allocated to the LPV/SQV/r arm. RESULTS At 48 weeks, the percentages of patients with plasma viral load<50 HIV-1 RNA copies/mL were 60% (31 of 52 patients) in the LPV/SQV/r arm vs 50% (six of 12) in the IDV/r/2NRTIs arm in the intent-to-treat (ITT) analysis, and 61% (31 of 51) vs 71% (five of seven), respectively, in the as-treated analysis. The median (interquartile range) increases in absolute CD4 cell count from baseline were 177 (91-269) and 100 (52-225) cells/microL in the LPV/SQV/r and IDV/r/2NRTIs groups, respectively (P=0.32). Four of 12 patients (33%) in the IDV/r/2NRTIs group experienced severe nausea and vomiting and four patients (8%) in the LPV/SQV/r group had significant hepatitis. CONCLUSIONS LPV/SQV/r and high-dose boosted IDV were not well tolerated and led to <65% ITT virological efficacy outcomes. A randomized larger scale study with new formulations and/or more tolerable boosted PIs in NNRTI-based failure is warranted.

UI MeSH Term Description Entries
D008297 Male Males
D004359 Drug Therapy, Combination Therapy with two or more separate preparations given for a combined effect. Combination Chemotherapy,Polychemotherapy,Chemotherapy, Combination,Combination Drug Therapy,Drug Polytherapy,Therapy, Combination Drug,Chemotherapies, Combination,Combination Chemotherapies,Combination Drug Therapies,Drug Polytherapies,Drug Therapies, Combination,Polychemotherapies,Polytherapies, Drug,Polytherapy, Drug,Therapies, Combination Drug
D005260 Female Females
D005838 Genotype The genetic constitution of the individual, comprising the ALLELES present at each GENETIC LOCUS. Genogroup,Genogroups,Genotypes
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D012367 RNA, Viral Ribonucleic acid that makes up the genetic material of viruses. Viral RNA
D015658 HIV Infections Includes the spectrum of human immunodeficiency virus infections that range from asymptomatic seropositivity, thru AIDS-related complex (ARC), to acquired immunodeficiency syndrome (AIDS). HTLV-III Infections,HTLV-III-LAV Infections,T-Lymphotropic Virus Type III Infections, Human,HIV Coinfection,Coinfection, HIV,Coinfections, HIV,HIV Coinfections,HIV Infection,HTLV III Infections,HTLV III LAV Infections,HTLV-III Infection,HTLV-III-LAV Infection,Infection, HIV,Infection, HTLV-III,Infection, HTLV-III-LAV,Infections, HIV,Infections, HTLV-III,Infections, HTLV-III-LAV,T Lymphotropic Virus Type III Infections, Human
D016879 Salvage Therapy A therapeutic approach, involving chemotherapy, radiation therapy, or surgery, after initial regimens have failed to lead to improvement in a patient's condition. Salvage therapy is most often used for neoplastic diseases. Salvage Treatment,Therapy, Salvage,Salvage Therapies,Salvage Treatments,Therapies, Salvage,Treatment, Salvage,Treatments, Salvage
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes

Related Publications

P Chetchotisakd, and S Anunnatsiri, and P Mootsikapun, and S Kiertiburanakul, and T Anekthananon, and C Bowonwatanuwong, and B Kowadisaiburana, and K Supparatpinyo, and K Ruxrungtham, and
Comparing albuvirtide plus ritonavir-boosted lopinavir regimen to two nucleotide reverse transcriptase inhibitors plus ritonavir-boosted lopinavir in HIV-infected individuals who failed initial treatment: a retrospective comparative cohort study.
October 2022, Annals of translational medicine,
P Chetchotisakd, and S Anunnatsiri, and P Mootsikapun, and S Kiertiburanakul, and T Anekthananon, and C Bowonwatanuwong, and B Kowadisaiburana, and K Supparatpinyo, and K Ruxrungtham, and
Relationship between plasma protease inhibitor concentrations and lipid elevations in HIV patients on a double-boosted protease inhibitor regimen (saquinavir/lopinavir/ritonavir).
April 2010, Journal of clinical pharmacology,
P Chetchotisakd, and S Anunnatsiri, and P Mootsikapun, and S Kiertiburanakul, and T Anekthananon, and C Bowonwatanuwong, and B Kowadisaiburana, and K Supparatpinyo, and K Ruxrungtham, and
Pharmacokinetics of lopinavir-ritonavir with and without nonnucleoside reverse transcriptase inhibitors in Ugandan HIV-infected adults.
July 2010, Antimicrobial agents and chemotherapy,
P Chetchotisakd, and S Anunnatsiri, and P Mootsikapun, and S Kiertiburanakul, and T Anekthananon, and C Bowonwatanuwong, and B Kowadisaiburana, and K Supparatpinyo, and K Ruxrungtham, and
Atazanavir and lopinavir/ritonavir: pharmacokinetics, safety and efficacy of a promising double-boosted protease inhibitor regimen.
May 2006, AIDS (London, England),
P Chetchotisakd, and S Anunnatsiri, and P Mootsikapun, and S Kiertiburanakul, and T Anekthananon, and C Bowonwatanuwong, and B Kowadisaiburana, and K Supparatpinyo, and K Ruxrungtham, and
Pharmacokinetics of high-dose lopinavir-ritonavir with and without saquinavir or nonnucleoside reverse transcriptase inhibitors in human immunodeficiency virus-infected pediatric and adolescent patients previously treated with protease inhibitors.
September 2008, Antimicrobial agents and chemotherapy,
P Chetchotisakd, and S Anunnatsiri, and P Mootsikapun, and S Kiertiburanakul, and T Anekthananon, and C Bowonwatanuwong, and B Kowadisaiburana, and K Supparatpinyo, and K Ruxrungtham, and
Efficacy and tolerability of a nucleoside reverse transcriptase inhibitor-sparing combination of lopinavir/ritonavir and efavirenz in HIV-1-infected patients.
July 2005, Journal of acquired immune deficiency syndromes (1999),
P Chetchotisakd, and S Anunnatsiri, and P Mootsikapun, and S Kiertiburanakul, and T Anekthananon, and C Bowonwatanuwong, and B Kowadisaiburana, and K Supparatpinyo, and K Ruxrungtham, and
Double boosted protease inhibitors, saquinavir, and lopinavir/ritonavir, in nucleoside pretreated children at 48 weeks.
July 2008, The Pediatric infectious disease journal,
P Chetchotisakd, and S Anunnatsiri, and P Mootsikapun, and S Kiertiburanakul, and T Anekthananon, and C Bowonwatanuwong, and B Kowadisaiburana, and K Supparatpinyo, and K Ruxrungtham, and
Pharmacokinetics of saquinavir, atazanavir, and ritonavir in a twice-daily boosted double-protease inhibitor regimen.
April 2007, Antimicrobial agents and chemotherapy,
P Chetchotisakd, and S Anunnatsiri, and P Mootsikapun, and S Kiertiburanakul, and T Anekthananon, and C Bowonwatanuwong, and B Kowadisaiburana, and K Supparatpinyo, and K Ruxrungtham, and
Safety and efficacy of a double-boosted protease inhibitor combination, saquinavir and lopinavir/ritonavir, in pretreated children at 96 weeks.
January 2009, Antiviral therapy,
P Chetchotisakd, and S Anunnatsiri, and P Mootsikapun, and S Kiertiburanakul, and T Anekthananon, and C Bowonwatanuwong, and B Kowadisaiburana, and K Supparatpinyo, and K Ruxrungtham, and
Virologic and immunologic outcomes of HIV-infected Ugandan children randomized to lopinavir/ritonavir or nonnucleoside reverse transcriptase inhibitor therapy.
April 2014, Journal of acquired immune deficiency syndromes (1999),
Copied contents to your clipboard!