[P13] Inter-individual variability of once daily boosted saquinavir (SQV/r) (Invirase(R)) in 18 HIV-1-infected patients on highly active antiretroviral therapy (HAART)

13th Annual Conference of the British HIV Association

29 March–1 April 2007, Brighton, UK

INTER-INDIVIDUAL VARIABILITY OF ONCE DAILY BOOSTED SAQUINAVIR (SQV/r) (INVIRASE^®) IN 18 HIV-1-INFECTED PATIENTS ON HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART)

HIV Med 2007; 8(Suppl. 1):13 (abstract no. P13)

Chinyere Okoli, David Ladenheim, Rajesh Varma and Chloe Orkin
Barts and The London NHS Trust, London, UK

AIMS: Illustrate inter-patient variability with boosted 2000 mg/100 mg SQV/r in a diverse clinic population using Invirase^® as part of HAART in an ethically diverse clinic cohort.

METHODS: Retrospective case note review. Patient characteristic, disease stage, treatment history, CDC stage, BMI, CD4 count, HIV-1 viral load (VL), concurrent medication noted and trough concentration (C_trough) from therapeutic drug monitoring (TDM) were recorded as part of routine clinical care using high performance liquid chromatography (HPLC) with patients on saquinavir/ ritonavir 2000 mg/100 mg od.

RESULTS: 18 patients identified, six (34%) protease inhibitor-naïve. Seven (39%) patients produced levels more than 10 times above minimum C_trough recommended for wild type (wt) virus (100 ng/mL). Three (17%) patients were below the minimum C_trough. 1/3 patients had detectable viraemia. Two (11%) patients reported adverse effects. Both were Black African women whose levels were 10 times above (C_trough). These patients were subsequently reduced to 1500 mg/100 mg od to good clinical effect (levels remained within therapeutic range).

Serum range (100 ng/mL for wt virus)	Number of patients
<100 ng/mL	3
100–500 ng/mL	4
500–1000 ng/mL	4
>1000 ng/mL	7

DISCUSSION: This study highlights the large inter-patient variability in once daily dosing saquinavir in an ethnically diverse cohort. Further detailed pharmacokinetic studies are warranted both to establish the long-term effects of elevated SQV/r levels and the efficacy of lowering the SQV/r dose based on TDM in PI experienced patients.

2007-03-29
P13

Copyright © 2007 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD