12th Annual Conference of the British HIV Association 29 March–1 April 2006, Brighton, UK

A RETROSPECTIVE ANALYSIS OF THE EFFICACY AND TOLERABILITY OF ANTIRETROVIRAL REGIMENS CONTAINING DUAL-BOOSTED PROTEASE INHIBITORS

HIV Med 2006; 7(Suppl. 1):14 (abstract no. P16)

Tabitha Mahungu, Colette Smith, Mervyn Tyrer and Margaret Johnson
Royal Free Centre for HIV Medicine, London, UK

AIMS: To describe the characteristics and evaluate the virological and immunological responses, toxicity and tolerability of regimens containing dual-boosted protease inhibitors (DBP).

METHODS: All subjects (n=178) who had ever been prescribed a regimen containing two protease inhibitors and low-dose ritonavir at our hospital were assessed retrospectively (observational study). The time of virological failure (VF) was defined as the date of the first of two consecutive viral load (VL) measurements >400 copies/ml (a) at any time for subjects initially <50 copies/ml; (b), more than 6 months since starting DBP for subjects starting DBP with VL >50 copies/ml (treatment changes and discontinuations ignored).

RESULTS: Subjects were predominantly male (83%), Caucasian (73%) and MSM (69%). At baseline, median CD4 count was 402 cells/µl (IQR: 213–586), median CD4 nadir 90 (20–198) cells/µl and 63 (35%) had a VL <50 copies/ml. 12 (7%) were previously treatment-naïve and 115 had experienced VF on a previous regimen. Median time previously spent on ART was 5.5 years, and median number of ARVs previously received was 5 (3–6). 127 (71%) were prescribed lopinavir-saquinavir, and 160 (90%) were receiving other ARVs simultaneously. Median length of follow-up was 18 months (m) (10–24) during which 71 (40%) discontinued DBP [reasons for discontinuation: GI symptoms (n=23), VF (n=18), abnormal lipids (n=6)]. No significant liver toxicity was observed. After 12, 18 and 24 months, 12% (95% CI: 7–18; Kaplan–Meier), 17% (11–23) and 28% (18–8) had experienced VF, respectively. At 6 and 18 months, median change in CD4 count from baseline was +63 (46, +186; n=148) and +91(20, +202; n=102) cells/µl.

CONCLUSION: DBP regimens in this treatment-experienced cohort study resulted in viral load suppression and CD4 count increase in the majority of subjects.

2006-03-29
P16

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