F1/2 - TRIZIVIR IN ARV NAÏVE HIV (+) PATIENTS: CAN IT STILL BE CONSIDERED AS A FIRST LINE TREATMENT OPTION?

9^TH EUROPEAN AIDS CONFERENCE (EACS)
1^st EACS RESISTANCE & PHARMACOLOGY WORKSHOP

October 25 - 29, 2003 Warsaw, Poland

7.5 Treatment Simplification

F1/2 - TRIZIVIR IN ARV NAÏVE HIV (+) PATIENTS: CAN IT STILL BE CONSIDERED AS A FIRST LINE TREATMENT OPTION?

* Astriti M.¹, Bugnon F.³, Bouberazi I.¹, Agher R.¹, Marcelin A.G.², Calvez V.², Bricaire F.¹, Raffi F.³, Katlama C.¹

(1) Dept. of Infectious Diseases,² Dept. of Virology, Pitie-Salpetriere Hospital, Paris, France,³ Dept of Infectious Disease, CHRU Hotel Dieu, Nantes, France

Background: Trizivir (TZV) has been reported to lack viral potency in ARV naïve patients.

Objective: To study the efficacy of TZV in ARV naïve patients and to define the reasons of virological failure.

Methods: Retrospective study evaluating first line treatment with TZV. Plasma VL and CD4 counts were evaluated at baseline, W12, W24, and W48. Resistance testing was performed in case of virological failure defined as VL>200cp/ml at any time after W12 (abstract submitted). Intent-to-treat (missing=failure) and as observed (AO) analyses were performed.

Results: A total of 120 patients were included. Baseline median VL was 4.92 log₁₀ [2.52-6.11] and CD4 cells 224 cells/mm³ [0-1210]. 28 % had AIDS. Over 48 weeks, 17 pts were lost to follow-up and 27 pts discontinued TZV either for intolerance (n=24) or virological failure (n=4), leaving 73 patients on TZV at W48. At W48, the % of pts with VL<200cp/ml by ITT was 58 % (70/120) and by AO 85 % (62/73); median changes in VL and CD4 were -2.40 log₁₀ cp/ml and +130 cells/mm³. After W12, 18 pts (15 %) had least one VL >200cp/ml, with a median value of 4.168 cp/ml (5 blips, 9 primary failures, 2 rebounds). Seven pts admited non-compliance.

Conclusions: Trizivir had a low rate of virological failure (15 %) in ARV naïve patients. Failures are mostly due to intolerance or non-compliance. However, after 2 years of follow-up, more than 50 % of patients are still on their initial TRZ regimen.

Presenting Author: Doctor Myrto Astriti, Services des Maladies Infectieuses et Tropicals du Pr. Bricaire, Hôpital Pitié-Salpétrière, 47-83, Boulevard de l' Hôpital, 75013, Paris, France, Phone: 00 33 1 42 16 02 93

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