3rd International AIDS Society Conference on HIV Pathogenesis and Treatment Rio de Janeiro - July 24 - 27, 2005

PHARMACODYNAMICS OF LOPINAVIR IN A COHORT OF 84 HIV INFECTED PATIENTS

IAS Conf HIV Pathog Treat 2005 Jul 24-27;3rd: Abstract No. WePe3.2C02

Wateba M.¹, Billaud E.¹, Dailly E.², Raffi F.^1
1 CISIH, Nantes, France, ² Pharmacology, Nantes, France

INTRODUCTION: Several studies have demonstrated a relationship between Cmin concentrations and efficacy of protease inhibitors. Nevertheless, drug monitoring is not yet considered as a routine evaluation. Systematic lopinavir trough concentration (LPV Ct) determination is not recommended but inter-patient variability could be responsible for less efficacy. We conducted a retrospective study on our HIV infected patients cohort to see whether lopinavir concentrations in routine monitoring had an influence on the virological response.

METHODS: 84 patients who had a LPV Ct determination within 10 days after initiation were included. Patients were classified in low concentration (LCt) when LPV Ct was below 3 mg/l, normal concentration (NCt) when LPV Ct was between 3 to 8 mg/ and high concentration (HCt) when LPV Ct was more than 8 mg/l. Demographic characteristics, antiretroviral history, concomitant conditions, clinical characteristics and virological response were studied. Virological success was defined by viral load below 200 copies/ml at month 3. Chi square and fisher's exact test were use for statistical analysis.

RESULTS: No difference was found between groups for age, BMI, CD4 cell count, viral load, and antiretroviral history at baseline. Mean LPV Ct for LCt, NCt and HCt group was respectively 1.56 ± 0.95 mg/l (n=18), 5.33 ± 1.47 mg/l (n=50) and 11.2 ± 2.7 mg/l (n=16). Virological success among LC, NC and HC group was respectively 22.2 %, 56% and 56. 25 % (p=0.018).

CONCLUSIONS: In this retrospective study, patients with a low LPV Ct within 10 days after initiation were more likely to have a virological failure at month 3. Considering the small number of patients it is not possible to find a risk factor for low LPV Ct. Larger prospective studies are needed to address this issue.

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Clinical | WePe3.2C02 | Francois Raffi
Pharmacological Monitoring Of Arv Therapy

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