7th Annual Conference Of The British HIV Association [BHIVA]


27 – 29 April 2001, The Hove Centre, Brighton

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[TITLE:] THE EFFICACY OF LOPINAVIR (ABT378) IN INDIVIDUALS EXPERIENCING PROTEASE INHIBITOR (PI) FAILURE

[AUTHOR(S):] MR Nelson, Y Gilleece, NA Qazi, JM Morlese, S Mandalia, BG Gazzard, A Pozniak
Chelsea and Westminster Hospital, London, UK

BHIVA Conf 2001 Apr 27-29;7:O6

AIM: To assess the efficacy and toxicity of ABT-378/ritonavir (ABT- 378/r) in PI-experienced patients.

METHODS: On-going review of ABT378/r-treated patients as part of the Abbott-sponsored compassionate-release programme.

RESULTS: Eighty-three patients received ABT378/r; 74 were male and 49 had a previous AIDS diagnosis. In 63 patients, the new regimen was based on a resistance test. The median number of PI mutations was four (range 0-8). The median number of active drugs (excluding ABT378/r) based on virtual phenotype was two. Eleven patients had not been treated with a non-nucleoside reverse transcriptase inhibitor. The median time on PI was 1280 days and on a nucleoside reverse transcriptase inhibitor, 2907 days.

Month n CD4 Viral load (HIV-1 RNA copies/ml) %TG %Chol
Median 1 log <500 <50 >10 >6.7
0 83 70 95298 - - - 3.6 4.9
1 79 171 702 89.2% 45% 4% 3.9 12.8
3 71 203 65 86.8% 74% 57% 4.6 20.0
6 52 225 <50 90.3% 76% 67% 5.0 25.0

TG, triglycerides; Chol, cholesterol (in mmol/l). CD4 count as cells/µl.

The response to ABT378 was associated with a higher CD4 count and lower viral load, number of active drugs in regimen and number of PI mutations. Fourteen patients ceased therapy, three due to disease progression, seven lost to follow-up, three due to virological failure and one due to toxicity.

CONCLUSIONS: Despite extensive PI experience, patients treated with a regimen containing ABT378/r had very high levels of response, with 76% of individuals on treatment at 6 months experiencing a viral load <500 HIV-1 RNA copies/ml and 67% <50 copies/ml.

PRESENTING AUTHOR: Y Gilleece

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