3rd International AIDS Society Conference on HIV Pathogenesis and Treatment


Rio de Janeiro - July 24 - 27, 2005

IMMUNOLOGIC AND VIROLOGIC RESPONSES WITH COMBINATION DIDANOSINE/TENOFOVIR COMPARED TO OTHER NUCLEOSIDE REGIMENS

IAS Conf HIV Pathog Treat 2005 Jul 24-27;3rd: Abstract No. WePe3-2C05

Furtek K.1, Crum N.F.2, Powell T.1, Hale B.2, Bavaro M.2, Truett A.2, Wallace M.R.2
1 Tri-Service AIDS Clinical Consortium (TACC), San Diego, United States of America, 2 Naval Medical Center San Diego, San Diego, United States of America

INTRODUCTION: Recent publications suggest the use of didanosine/tenofovir (ddI+TDF) may result in poor virologic and immunologic response rates in naïve HIV-infected patients. We evaluated the immunologic and virologic responses of ddI+TDF in our clinic of treatment experienced patients.

METHODS: We performed a retrospective analysis comparing CD4 and virologic response rates in 25 non-naïve HIV-infected patients receiving ddI 250mg/day plus TDF 300mg/day as their nucleoside backbone. Patients were matched on a 1:1 basis by number of previous antiretroviral regimens and other antiretroviral agents (i.e. protease inhibitor, non-nucleoside or additional nucleoside reverse transcriptase inhibitor). Control patients received lamivudine or emtricitabine plus TDF (3TC/FTC + TDF). Descriptive statistics were performed and the two treatment groups were compared using Hotelling's T-test (STATA 8.2 software).

RESULTS: We studied 50 patients with a mean age of 44.0 years who were treatment experienced (mean number of previous regimens = 7). At baseline, the two groups did not differ by age, number of HIV regimen, baseline CD4 count, or HIV viral load. After 3-6 months of therapy, there were no statistically significant differences between the two groups in terms of CD4 (p=0.92) or CD8 (p=0.94). However, there was an inferior virologic response among the ddI+TDF group (p=0.05). (Column 1: Parameter, Column 2: ddI+TDF(n=25), Column 3: 3TC/FTC+TDF (n=25))
Mean Baseline CD4 (cells/mm³) 347 (9 – 685) 409 (8 – 817)
Mean Baseline Ln
VL		 7.5 (3.91 – 11.51) 7.8 (3.91 – 11.51)
Mean CD4 at 3 – 6 months (cells/mm³) 370 (6 – 814) 435 (27 – 861)
Mean Change in CD4 from Baseline (cells/mm³) +22.5 [-287-(+324)] +25.4 [-252-(+381)]
Mean Ln VL at 3 – 6 months 6.4 (3.91 – 11.43) 4.9 (3.91 – 11.26)
Mean Change in Ln VL from Baseline -1.1 [+4.9-(-7.6)] -2.9 [+0.99-(-7.26)]

CONCLUSIONS: Combination ddI/TDF produced similar immunologic response rates, but less VL reduction than 3TC/FTC+TDF among treatment-experienced patients. Though this combination may not be an optimal backbone, it may be a viable backbone in highly experienced patients.

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Clinical | WePe3.2C05 | Furtek K.
Pharmacological Monitoring Of Arv Therapy

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