|
Seventh International Congress on Drug Therapy in HIV InfectionGlasgow, UK - 14-17 November 2004 |
Cite as: Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. xx
| PLENARY KEYNOTE LECTURES |
|
| KL1 | [KL1] ANTIRETROVIRAL THERAPY 2004 Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. KL1 Patrick Yeni Since it became clear that HIV infected patients might need a lifelong toxic therapy, efforts were developed in two directions: A limitation in drug exposure, and an improvement in drug characteristics. |
| KL2 | PREVENTION AND CONTROL OF GLOBAL HIV/AIDS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. KL2 Helene Gayle Although effective treatment for HIV is widely available in rich countries, they are not in widespread use in poor countries where the problem is greatest. Major impediments to access to antiretroviral drugs are the cost and the lack of stable health care infrastructures to administer and monitor what are rather complex treatment regiments. However, many efforts are underway to accelerate access to antiretroviral therapies in resource poor setting. Absent antiretroviral drugs, treatment of associated infections can have a substantial impact of improving the health of people with HIV infection. For example, tuberculosis, a treatable infectious disease, is the leading cause of death for people with HIV in developing countries. |
| KL3 | [KL3] HIV HOST GENETICS: DIFFERENT PEOPLE, DIFFERENT DISEASE Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. KL3 Amalio Telenti Pharmacogenetics and pharmacogenomics, toxicogenetics and immunogenetics are the disciplines that are expected to deliver the future personalized medicine. This endeavor requires means to identify genes that are variant, and demands that genetic variants undergo biological and clinical validation. Implementation depends on obtaining a complete picture of the complex trait (multigene) nature of many clinical phenotypes. Detection needs the appropriate laboratory techniques, in the context of ethical limits to genetic testing. |
| SESSION 1: TREATMENT STRATEGIES |
|
| PL1.1 | [PL1.1] ANTIRETROVIRAL TREATMENT: WHAT TO START? Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL1.1 Roy M. Gulick Some initial therapy regimens have demonstrated HIV RNA suppression rates exceeding 70-80% for up to 1-4 years. In addition, documentation of both increasing rates of drug resistance in untreated HIV-infected individuals and an increased risk for virologic failure on initial treatment regimens in this group supports routine baseline resistance testing in some groups of patients. Current options and management strategies for the initial treatment of HIV infection continue to evolve and it is critical to interpret and incorporate newer data into the current standard of care. |
| PL1.2 | [PL1.2] CAN ANTIRETROVIRAL TREATMENT BE SIMPLIFIED OR WILL TRIPLE REGIMENS REMAIN THE GOLD STANDARD? Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL1.2 Pietro L. Vernazza Two major concerns remain with the use of PI-mono therapies: Given the high frequency of HIV-RNA blips, the long-term effect of this treatment strategy needs to be evaluated in larger studies. The second concern relates to the poor penetration of some PIs into sanctuary like brain and genital tract. Long-term studies which also investigate the effect of treatment in CSF are warranted. |
| PL1.3 | [PL1.3] SALVAGE THERAPY Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL1-3 Brian G. Gazzard The belief of most clinicians and a post hoc analysis of the major studies performed with T20 (TORO 1 and 2) would suggest that these drugs would be better used in combination with other active agents and, therefore, the best method of treatment in salvage is to prevent it from occurring by using agents more judiciously at an earlier stage of disease. A number of other agents including new nucleosides, new NNRTIs, Capaverine and TMC125, and novel agents attacking either integrase or the process of interaction either between the CD4 receptor and GP120 or between CCR5 and GP 41 should also be licensed in the foreseeable future which gives further hope to people in this situation. |
| PL1.4 | [PL1.4] STRUCTURED TREATMENT INTERRUPTIONS (STI) IN THE MANAGEMENT OF HIV INFECTED INDIVIDUALS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL1-4 Julio Montaner In an attempt to limit drug exposure (for reasons such as adherence, toxicity, cost) several groups are currently evaluating CD4+ guided therapy interruptions. This form of intermittent or pulse therapy is not expected to provide a direct immunologic or virologic benefit. To date, this approach appears to be comparable to the continuous therapy arm in several ongoing studies. However, concerns have emerged regarding premature development of resistance in highly adherent patients following such treatment interruptions. Consequently, full evaluation of long-term results of such strategy studies will be needed before the possible role of this approach is fully understood. Until then, the only acceptable use of treatment interruptions in clinical practice today pertains to allow recovery from side effects or co-morbidities. |
| SESSION 2: TREATMENT STRATEGIES AND ORAL PAPERS |
|
| PL2.1 | [PL2.1] USE OF BOOSTED PROTEASE INHIBITORS: PROS AND CONS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL2-1 Schlomo Staszewski Patients with prior, extensive PI-resistant virus did not fare as well. This suggests that a double-boosted PI regimen is an effective salvage therapy in specific situations. The association between higher number of PI mutations and reduced likelihood of response suggests that the optimal indication for the use of such a regimen would be in patients with virologic failure of prior PI-sparing regimens, who may have reduced RTI options but retain PI-susceptible virus or in patients with low to moderate PI resistance. In contrast, patients with late-stage failure and extensive PI resistance should probably receive double-boosted PIs plus enfuvirtide and other active agents if available. |
| PL2.2 | [PL2.2] TREATMENT PREPAREDNESS: READYING COMMUNITIES FOR ANTIRETROVIRAL THERAPY Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL2.2 Gregg Gonsalves Treatment access is also often hindered by the failure of governments to make and/or follow through on commitments to implement HIV treatment programs and/or implement them in an equitable manner; appropriate funds for HIV treatment and care; and enact and enforce laws and regulations to protect against HIV-related discrimination. The private sector frequently has imposed obstructions to treatment access as well through inadequate workplace policies and impractical pricing of pharmaceutical, diagnostic tests and other medical products. |
| PL2.3 | [PL2.3] EVOLUTION OF TRANSMITTED WILD-TYPE AND DRUG RESISTANT INFECTIONS IN PRIMARY HIV INFECTION Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL2.3 Mark A. Wainberg, Dan Turner, Bluma Brenner, Daniella Moisi, Maureen Oliveira, Jean Pierre Routy We performed a longitudinal analysis to characterize the differential evolution of transmitted wild-type (WT) and drug resistant infections over time in primary HIV infection (PHI). We evaluated genotypic changes over time (2-6 years) in 31 PHI subjects. |
| PL2.4 | [PL2.4] RANDOMISED COMPARISON OF MAINTENANCE THERAPY WITH TRIZIVIR [TZV] + EFAVIRENZ [EFV] VS TZV IN NAÏVE HIV-1 INFECTED SUBJECTS: TIME STUDY Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL2.4 S. De Wit1, M. Johnson2, B. Gazzard3, J.F. Bergmann4, J. Reynes5, V. Estrada6, A. Castagna7, J. Rockstroh8 Simplification to TZV maintenance after TZV/EFV induction therapy reduces drug-related events, reduces fasting cholesterol and maintains an immunological and virologic response compared to continuous TZV/EFV therapy. |
| PL2.5 | [PL2.5] EARLY VIROLOGICAL FAILURE IN PERSONS WITH VIRAL LOADS > 100 000 COPIES/mL AND CD4 COUNTS < 200/mm³ RECEIVING DIDANOSINE(DDI)/TENFOVIR(TDF)/EFAVIRENZ(EFV): 12 WEEK RESULTS FROM A RANDOMISED COMPARATIVE TRIAL Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL2.5 D. Maitland, G. Moyle, J. Hand, M. Nelson, B. Gazzard TDF/ddI/EFV as initial therapy appears to have diminished efficacy in subjects with baseline viral loads >100 000 copies/ml and CD4 counts < 200/mm³. Failure was not attributable to poor adherence. |
| SESSION 3: |
|
| PL3.1 | [PL3.1] SALVAGE THERAPY FORUM FEEDBACK Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL3-1 Veronica Miller Abstract not available |
| PL3.2 | [PL3.2] PHASE 3 COMPARISON OF LOPINAVIR/RITONAVIR VS. INVESTIGATOR-SELECTED PROTEASE INHIBITORS IN SINGLE PI-EXPERIENCED, NNRTI-NAÏVE PATIENTS: 48-WEEK RESULTS OF STUDY M98-888 Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL3-2 R.B. Pollard1, M.A. Thompson2, C.B. Hicks3, B. Grinsztejn4, A. Horban5, M.S. King6, M. Norton6, P.A. Cernohous6, S.C. Brun6, J.H. Omachi6 A LPV/r-based regimen demonstrated superior virologic efficacy and better tolerability in single PI-experienced pts, vs. a regimen based on investigator-selected PIs. |
| SESSION 4: RESOURCE-POOR SETTINGS [IAS SESSION] |
|
| PL4.1 | [PL4.1] The challenges for controlling maternal-child transmission in resource poor settings Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL4.1 Glenda E. Gray Mother-to-child-transmission of HIV (MTCT) can occur before, during and after delivery. Most of transmission occurs during late pregnancy and delivery, and in resource poor settings, breastfeeding contributes substantially to the overall risk. Other risk factors for MTCT include advanced maternal disease, prematurity; |
| PL4.2 | [PL4.2] Virtues of "opt-out" testing as the point of entry to expanded access to ART in developing countries Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL4.2 Ferdinand M. Mugusi The use of effective antiviral agents has significantly improved the prognostic possibilities for many people with AIDS in the developed world. There are initiatives by WHO and other international organizations to expand access to Antiretroviral therapy (ART) to as many people as possible, especially in high prevalent |
| PL4.3 | [PL4.3] Treatment access and other challenges for clinicians in Eastern Europe Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL4.3 Lars Kallings Russian Federation and other countries in Eastern Europe continues to have one of the fastest growing HIV epidemics in the world, the actual number of individuals living with HIV/AIDS in Russia alone is estimated to be from 600.000 to 1 million and in the whole region more than 1.5 million. There are a rapidly increasi |
| PL4.4 | [PL4.4] Treatment outcomes for antiretroviral therapy in a routine clinical setting in Kampala, Uganda Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL4.4 M.R. Kamya1, L.A. Spacek2, H.M. Shihab3, D. Mwesigire3, A. Ronald3, H. Mayanja1, R.D. Moore2, T.C. Quinn2 To evaluate response to antiretroviral therapy (ART) in Kampala, Uganda . We conducted a cross-sectional study of 137 HIV-infected patients on ART at Mulago Hospital Infectious Diseases Clinic. We measured prevalence of viral suppression, evaluated predictors of response to ART and documented phenotypic resistance patt |
| PL4.5 | [PL4.5] Access to treatment in Botswana 2 years on Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL4.5 Segolame Lekoko Ramotlhwa The National Anti-retroviral Therapy (ART) Program in Botswana is called Masa. Masa is a Setswana (local language) word for new dawn and the program was given this name in 2001 as a reflection of new hope for people living with HIV/AIDS (PLWA S). The Masa ART Program was launched in August 2001 following a Consultancy |
| SESSION 5: ADHERENCE, RESISTANCE, CLINICAL PHARMACOLOGY AND DISEASE MONITORING |
|
| PL5.1 | [PL5.1] ADHERENCE, RESISTANCE AND DISEASE MONITORING Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL5.1 Rainer Weber Intervention strategies to improve adherence include cognitive-behavioural methods, behavioural strategies, directly observed therapy, and affective strategies. In resource-limited settings adherence can be achieved by strengthening community-based efforts. In summary, monitoring adherence and promoting tailored socio-behavioural support is an integral part of antiretroviral therapy and patient care. |
| PL5.2 | [PL5.2] SIMILAR ADHERENCE RATES FAVOUR DIFFERENT VIROLOGIC OUTCOMES ACCORDING TO TYPE OF HAART Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL5.2 Franco Maggiolo1, Laura Ravasio2, Diego Ripamonti1, Giampietro Gregis1, Giampaolo Quinzan1, Monica Airoldi2, Fredy Suter2 Adherence is a major determinant of HAART success and, in our study, highly correlates to virologic success of HAART within the following 6 months. NN-based therapies seem to have a higher degree of forgiveness in those patients with intermediate adherence (>75% but < 100%). Simpler regimens favor a significantly higher level of adherence. VAS is a simply reliable instrument for assessing adherence. |
| PL5.3 | [PL5.3] EPIDEMIOLOGY OF ANTIRETROVIRAL RESISTANCE Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL5.3 Deenan Pillay/ Unfortunately, existing datasets vary significantly in the types of population surveyed, and definitions of resistance, making it difficult to draw clear conclusions on these issues. It is essential to identify the precise purpose for estimating for epidemiological analysis before implementing optimal methological approaches. |
| PL5.4 | [PL5.4] EFFECTS OF MUTATIONS ASSOCIATED WITH SUPPRESSION OF ZIDOVUDINE RESISTANCE IN HIV-1 REVERSE TRANSCRIPTASE ON REMOVAL OF TENOFOVIR FROM BLOCKED PRIMER/TEMPLATE Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL5.4 Narges Hassani Espili, Alona Pavlova, Tobias Bergroth, Anders Sönnerborg, Johan Lennerstrand The M184V, Y181C and L100I mutation reduces the ATP mediated excision of incorporated tenofovir. Thus, our biochemical data is consistent with cell culture data. This indicates that there would be a benefit with tenofovir therapy combined with therapy rendering suppression mutations. |
| SESSION 6: RESISTANCE AND PHARMACOKINETICS |
|
| PL6.1 | [PL6.1] LONG TERM RISK OF DEVELOPMENT OF DRUG RESISTANCE AFTER STARTING ANTIRETROVIRAL THERAPY IN ROUTINE CLINICAL PRACTICE Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL6.1 A. Phillips, D. Dunn, C. Sabin, A. Pozniak, R. Matthias, A. Geretti, J. Clarke, D. Churchill, I. Williams, T. Hill, H. Green, K. Porter, G. Scullard, M. Johnson, P. Easterbrook, R. Gilson, M. Fisher, C. Loveday, B. Gazzard, D. Pillay In routine practice, rates of viral load failure and of resistance detection in patients who started ART with three or four drugs are appreciable. |
| PL6.2 | [PL6.2] DRUG-DRUG INTERACTIONS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL6.2 David Back HIV medicine is rife with proven and potential drug-drug interactions. Although many interactions can be predicted on the basis of preclinical pharmacology, and regulatory agencies require PK studies when a significant interaction is anticipated, there are still many drug combinations that have been inadequately studied. Given also that unexpected interactions appear and unexpected failures of certain drug combinations occur, there is the need to have some understanding of the concentrations of antiretroviral drugs achieved in an individual patient. Here is a role for therapeutic drug monitoring. |
| PL6.3a | [PL6.3a] EFFECT OF ATAZANAVIR ON INTRACELLULAR AND PLASMA PHARMACOKINETICS OF SAQUINAVIR AND RITONAVIR ADMINISTERED ONCE-DAILY IN HIV INFECTED PATIENTS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL6.3a Jennifer Ford1, Marta Boffito2, Adrian Wildfire2, Andrew Hill3, David Back1, Saye Khoo1, Mark Nelson2, Graeme Moyle2, Brian Gazzard2, Anton Pozniak2 ATV increased both plasma and IC exposure (AUC0-24h) and Cmin of SQV but not RTV. Addition of ATV to a QD SQV/RTV regimen maybe useful for patients with SQV concentrations below the minimum effective concentrations, however, further efficacy studies are warranted. |
| PL6.3b | [PL6.3b] INTRACELLULAR AND PLASMA PHARMACOKINETICS OF SAQUINAVIR, ATAZANAVIR AND RITONAVIR (SQV/ATV/R) 1600/200/100mg ADMINISTERED ONCE DAILY IN HIV INFECTED PATIENTS/TI> Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL6.3b Jennifer Ford1, Marta Boffito2, Adrian Wildfire2, Andrew Hill3, David Back1, Saye Khoo1, Mark Nelson2, Graeme Moyle2, Brian Gazzard2, Anton Pozniak2 IC concentrations were higher than plasma concentrations for all PIs measured. Mechanisms of IC PI accumulation are unclear but may reflect affinities for influx transporters, since no relationships with efflux transporters were observed. |
| PL6.4 | [PL6.4] CHALLENGES IN INTEGRATING RESISTANCE, FITNESS AND DRUG LEVELS INTO OUR CLINICAL PRACTICE, NOW AND IN THE FUTURE Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL6.4 Jonathan M. Schapiro The optimal use of antiretroviral agents requires integration of all these tests. Choices on which protease inhibitor to use and at what dose in heavily drug-experienced patients is an example of how both resistance and pharmacology data need to be integrated. But in addition to our refinements and improvements in assay development and interpretation, there is an urgent need to draw from our experience with these tests to improve treatment where they cannot be afforded. By analyzing large databases with sophisticated statistical techniques, we may be able to improve treatment algorithms for patients in resource poor settings. This insight may allow us to improve therapeutic choices based on patient characteristics and drug history, even when expensive testing is not feasible. |
| PL6.5 | [PL6.5] GENOTYPIC AND PHENOTYPIC INHIBITORY QUOTIENTS AS PREDICTORS OF THE VIROLOGICAL RESPONSE TO A RITONAVIR/AMPRENAVIR CONTAINING REGIMEN IN HIV-1 PROTEASE INHIBITOR EXPERIENCED PATIENTS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL6.5 A.G. Marcelin1, C. Delaugerre1, N. Ktorza1, H. Ait-Mohand1, M. Wirden1, A. Simon1, C. Lamotte 2, P. Bossi1, F. Bricaire1, D. Costagliola1, C. Katlama1, G. Peytavin2, V. Calvez1 APV harbored high PIQs on resistant strains that is in accordance with an efficacy when boosted by RTV in PI experienced patients. The predictive value of APV IC50 or fold change used alone are enhanced taking account of APV Cmin using a PIQ approach. |
| PL6.6 | [PL6.6] THE NORMALISED INHIBITORY QUOTIENT OF BOOSTED PROTEASE INHIBITORS IS PREDICTIVE OF VIRAL LOAD RESPONSE OVER 48 WEEKS IN A COHORT OF HIGHLY TREATMENT EXPERIENCED HIV-1 INFECTED INDIVIDUALS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL6.6 A. Winston1, G. Hales1, J. Amin1, E. van Schiack2, L. Bacheler3, B. Winters2, D. Cooper1, S. Emery1 In this cohort of highly treatment-experienced individuals treated with boosted PI regimens, baseline VL and NIQ were significantly predictive of virological response over 48 weeks. These prospective results support the use of a NIQ at week four, as a tool in predicting response to therapy in this setting. |
| SESSION 7: ADVERSE EVENTS I |
|
| PL7.1 | [PL7.1] PATHOGENESIS AND TREATMENT OF METABOLIC COMPLICATIONS OF HIV THERAPY Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL7-1 Peter Reiss Although interventions aimed at established fat maldistribution thus far have not been very effective, the earlier mentioned demonstrated differences between particular drugs do offer promise for establishing combination therapy strategies (e.g. involving novel NRTI backbones such as abacavir+lamivudine or tenofovir+emtricitabine) which may be associated with a reduced or at least delayed incidence of lipodystrophy. |
| PL7.2 | [PL7.2] Living with adverse events: how does it affect adherence and decisions on starting or changing therapy? Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL7-2 Kevin Moody Everyone taking antiretroviral treatment (ART) experiences adverse events, the type and extent of which vary greatly from person to person and cannot be predicted. Induction side effects decrease over time and can be managed, while long-term metabolic side effects are even less predictable and less is known about how t |
| PL7.3 | [PL7.3] MITOCHONDRIAL STUDIES IN ADIPOSE TISSUE OF HIV-INFECTED PATIENTS WITHOUT FAT REDISTRIBUTION Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL7-3 S. López1, G. Garrabou1, E. Martínez2, P. Domingo3, J. Fontdevila4, J.M. Gatell2, A.B. Infante1, X. Gallart5, A. Milinkovic2, F. Cardellach1, J. Casademont1, Miró1 Decreased mtDNA content in AT of HIV-infected patients is closely associated with decreased COX activity, irrespective of the presence of HAART, before LD appears. The exact role that HIV itself and HAART play in adipocyte changes remains to be determined. |
| PL7.4 | [PL7.4] Control and treatment of coronary heart disease risk factors in HIV-infected patients: the Swiss HIV cohort study Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL7-4 H.C. Bucher, T.R. Glass, C. Ungsedhapand, Swiss HIV Cohort Study To examine the extent of control and treatment of CHD risk factors in both treated and untreated individuals in the Swiss HIV Cohort Study (SHCS). Since April 1, 2000, HIV-infected individuals enrolled in the SHCS are biannually assessed for CHD risk factors and cardiovascular events. All scheduled visits with lab valu |
| PL7.5 | [PL7.5] NANDROLONE DECANOATE COMPARED WITH PLACEBO AND TESTOSTERONE FOR HIV ASSOCIATED WASTING: A MULTI-CENTRE INTERNATIONAL CLINICAL TRIAL Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL7-5 Julian Gold1, Marijka Batterham1, Peggy M.E. Helmyr3, Marloes Harms 3, Hans Rekers3 This is the first multi-centre clinical trial of its type which provides important evidence to assist clinicians to manage patients with HIV wasting. Treatment with ND increases body weight when compared with placebo and T. ND treatment results in greater increases in FFM than placebo and demonstrates a trend to a significant increase when compared with T. |
| PL7.6 | [PL7.6] THE EFFECTS OF NANDROLONE DECANOATE ON WEIGHT LOSS AND QUALITY OF LIFE IN MALE PATIENTS WITH ACQUIRED IMMUNODEFICIENCY SYNDROME Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL7-6 Chris J. Duncombe, Theshinee Chuenyam, Paul T. Geurts, Marloes K. Harms, Praphan Phanuphak This was a multi-center, randomized, double blind, placebo controlled study of the effects of 24 weeks of treatment with ND in three different doses in the prevention or delay of weight loss and on quality of life in HIV-infected male patients. Subjects with 5-15% weight loss, stable on antiretroviral therapy for a minimum of eight weeks or on no antiretroviral therapy, were randomized to receive ND 50 mg, 100 mg or 150 mg by intramuscular injection once every two weeks or placebo. Efficacy was assessed by mean changes in body weight, LBM and anthropometry. Quality of life was measured using the MOS-SF30 questionnaire. |
| SESSION 8: IMMUNOLOGY, IMMUNE-BASED THERAPIES AND VACCINES |
|
| PL8.1 | [PL8.1] What is the status of IL-2? Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL8.1 Jens D. Lundgren PURPOSE OF PRESENTATION: Provide an update on the current research efforts directed towards defining the potential clinical utility of interleukin 2 ( IL-2 ) in slowing the progression of HIV-1 infection. SUMMARY OF RESULTS: An extensive phase II database has established that intermittent 5 day cycles of IL-2 are capab |
| PL8.2 | [PL8.2] Where are we with vaccines? Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL8-2 Jonathan Weber Abstract not available |
| PL8.3 | [PL8.3] Vaccine preparedness: building up an enabling environment for AIDS vaccines clinical research Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL8.3 Maite Suarez The goal of the International AIDS vaccines Initiative (IAVI) is to accelerate the development and subsequent use of a safe, efficacious and affordable AIDS vaccine for the world, and particularly for those regions most affected by the epidemic; hence, IAVI s commitment to developing a vaccine in and for these regions |
| SESSION 9: HIV-RELATED INFECTIONS, CO-INFECTIONS AND MALIGNANCIES |
|
| PL9.1 | [PL9.1] The management of tuberculosis in HIV infected patients Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL9-1 James Hakim In 2000 it was estimated that 9% of the 8.3 million new cases of tuberculosis in adults aged 15 to 49 years were HIV co-infected. Dual infection reaches its greatest extent in the developing world, but is important worldwide. The management of tuberculosis in HIV infected patients poses several challenges. These includ |
| PL9.2 | [PL9.2] Kaposi sarcoma herpesvirus: update Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL9.2 Chris Boshoff The incidence of HIV-related cancer before and during the ART era indicates that oncogenic viruses continue to contribute to the majority of these cancers and they are therefore considered opportunistic malignancies. ART has lead to a definitive decline in the incidence of certain AIDS-defining cancers including Kaposi |
| PL9.3 | [PL9.3] Similar profile of adverse events during treatment for tuberculosis in patients with and without HIV co-infection Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL9.3 Ronan Breen1, Robert Miller2, Jayne Ballinger1, Leonie Swaden1, Margaret Johnson1, Marc Lipman1 To describe the adverse events profile when both HAART and anti- tuberculosis medication are used together. Case-note review of 115 patients with active HIV/TB coinfection, compared to 114 unselected HIV negative TB patients treated over the same time period at our institution. HIV+ TB+ patients had a median age of |
| PL9.4 | [PL9.4] Co-infection with syphilis: natural history and management Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL9.4 Fiona Mulcahy WHO estimates approximately 12 million new cases of syphilis each year, the majority occurring in the developing world. In the last four years, however discrete outbreaks of syphilis have been reported in North America, United Kingdom, Ireland and Western Europe, where previous rates had been rela |
| PL9.5 | [PL9.5] HIV and syphilis: when to perform a lumbar puncture? Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL9.5 A. Libois1, S. De Wit1, B. Poll1, M. Hildebrand1, E. Florence2, M. Vandenbruaene2, F. Garcia3, A. Del Rio4, P. Sanchez5, E. Negredo6, J.M. Gatell3, N. Clumeck1 HIV+ patients (P) with syphilis (S) are considered to be at increased risk for neuroS (NS). Whether this should prompt to systematic lumbar puncture (LP) remains controversial. This study aims to establish whether it is possible to optimize the use of LP by defining specific situations in which it should be performed. |
| SESSION 10: HEPATITIS CO-INFECTIONS AND ADVERSE EVENTS II |
|
| PL10.1 | [PL10.1] HBV and HCV co-infection: natural history and management Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL10.1 Yves Benhamou Abstract not available. SESSION 10: HEPATITIS CO-INFECTIONS AND ADVERSE EVENTS II |
| PL10.2 | [PL10.2] Hepatic adverse events (with and without coinfection) Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL10.2 Jürgen Rockstroh Meanwhile the benefits of highly active antiretroviral therapy (HAART) with regard to both survival and quality of life have been demonstrated beyond any doubts. Yet, HAART-associated toxicity has evolved as the main reason to discontinue or modify antiretroviral therapy. Hepatotoxicity appears to be of particular impo |
| PL10.3 | [PL10.3] HAART-associated hepatotoxicity in HIV/HCV co-infected patients: the role of liver histologic damage and drug levels Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL10.3 Lidia Aranzabal, Jose L. Casado, Javier Moya, Ana Marin, Carmen Quereda, Ana Moreno, Santiago Moreno HCV infection is a known risk factor for hepatotoxicity in HIV-infected patients. The aim of this study was to asses the influence of liver histologic stage in the rate of HAART-related liver toxicity. Prospective cohort study of 107 HIV/HCV co-infected patients who underwent liver biopsy between October 00 and Septemb |
| PL10.4 | [PL10.4] Is osteoporosis real? Pathogenesis and management Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL10.4 William G. Powderly Bone disorders have emerged in the last five years as potentially an additional long-term complication of HIV infection and/or its treatment. Osteonecrosis, especially involving large joints, has been linked to the duration of antiretroviral therapy. Multiple studies suggest that HIV-infected patients receiving potent |
| SESSION 11: PAEDIATRIC INFECTION |
|
| PL11.1 | [PL11.1] Paediatric issues relevant to the clinical management of HIV-infected adults Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL11.1 Carlo Giaquinto Children differ from adults in the natural history of HIV-1 infection, immunology, virology patterns of drug tocixity and adherence related issues. The response of the immune system is very specific and different in adults and children: children have an active thymus and a greater capacity than adults to regenerate the |
| PL11.2 | [PL11.2] Higher nevirapine doses correlate with improved outcomes in a paediatric population Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL11.2 A. Alexanian1, S. Gibbons2, E.G.H. Lyall1, S. Walters1, S. Khoo2, G. Tudor-Williams1 PURPOSE OF THE STUDY: To determine the dose-trough and trough-outcome relationship for nevirapine (NVP) given as part of combination antiretroviral therapy (CART) to a paediatric population. METHODS: From the database held at the Liverpool TDM service, results of all NVP assays obtained from children from 1999 to Septe |
| PL11.3 | [PL11.3] Antiretroviral therapy and pregnancy outcome: UK/Ireland surveillance data 1990-2004 Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL11.3 Pat A. Tookey, Claire L. Townsend, Mario Cortina-Borja, Janet E. Masters, Catherine S. Peckham;;; Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, London, UK To describe trends in the use of antiretroviral therapy (ART) in pregnancy in the UK and Ireland, and associations between ART use and pregnancy outcome. Pregnancies in women with diagnosed HIV are notified to the National Study of HIV in Pregnancy and Childhood (NSHPC) through a confidential voluntary active reportin |
| SESSION 13: NEW TREATMENTS AND TARGETS, LATE BREAKERS AND HOT TOPICS |
|
| PL13.1 | [PL13.1] NEW ANTIRETROVIRALS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL13.1 Robert Murphy Abstract not available |
| PL13.2 | [PL13.2] REPRODUCTION IN HIV-INFECTED COUPLES Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL13.2 Simone Fiore Abstract not available |
| PL13.3 | [PL13.3] Benefit of antiretroviral therapy for serodiscordant couples willing to be parents Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL13.3 Pablo Barreiro, Vincent Soriano, Marina Nuñez, Juan Gonzalez-Lahoz;;; Infectious Diseases, Hospital Carlos III, Madrid, Spain HIV+ persons who wish to be parents with a HIV-neg partner may pose at risk of infection the couple and eventually the newborn. To minimize this risk, in vitro fertilization is often advised in such cases. However, this is an expensive procedure. Furthermore, social and personal believes often discourage some couples f |
| SESSION 14: LATE BREAKERS AND HOT TOPICS |
|
| PL14.1 | [PL14.1] WHY DO PATIENTS STOP ANTIRETROVIRALS USED AS PART OF AN INITIAL HAART REGIMEN? RESULTS FROM THE EUROSIDA STUDY GROUP Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL14.1 A. Mocroft1, A. Phillips1, V. Soriano2, J. Rockstroh2, A. Blaxhult2, C. Katlama2, A. Boron-Kaczmarska2, L. Viksna2, O. Kirk2, J. Lundgren2 Patients with HCV were more likely to discontinue their first HAART regimen due to toxicity or patient/physician choice. Managing adverse events must remain a key intervention in maintaining HAART. There is a need for further studies to describe the relationship between HCV, specific antiretrovirals and different treatment strategies. |
| PL14.2 | [PL14.2] THE COMBINATION OF TENOFOVIR DF (TDF), EMTRICITABINE (FTC) AND EFAVIRENZ (EFV) HAS SIGNIFICANTLY GREATER RESPONSE VS FIXED DOSE ZIDOVUDINE/LAMIVUDINE (CBV) AND EFV IN ANTIRETROVIRAL NAÏVE PATIENTS: A 24-WEEK PRELIMINARY ANALYSIS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL14.2 J.R. Arribas1, E. DeJesus2, R. Campo3, J. Jemsek4, J.E. Gallant5, B. Gazzard6, A.L. Pozniak6, B. Lu7, M.D. Miller7, A. Cheng7, For the Study 934 Team Through week 24, the combination of TDF, FTC and EFV resulted in a significantly greater number of patients achieving and maintaining HIV RNA < 400 and < 50 c/mL vs CBV+EFV with fewer discontinuations due to adverse events. |
| PL14.3 | [PL14.3] 24-WEEK DATA FROM RESIST 2: PHASE 3 STUDY OF THE EFFICACY AND SAFETY OF EITHER TIPRANAVIR/RITONAVIR (TPV/R) OR AN OPTIMIZED RITONAVIR (RTV)-BOOSTED STANDARD-OF-CARE (SOC) COMPARATOR PI (CPI) IN A LARGE RANDOMIZED MULTICENTER TRIAL IN TREATMENT-EXPERIENCED HIV+ PATIENTS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL14.3 Pedro Cahn Results indicate that TPV/r provides superior antiretroviral activity to currently available CPI/r in a cohort of treatment-experienced HIV+ patients. |
| PL14.4 | [PL14.4] COMPARISON OF ATAZANAVIR (ATV) WITH RITONAVIR OR SAQUINAVIR VS LOPINAVIR/RITONAVIR IN PATIENTS WITH MULTIPLE VIROLOGIC FAILURES: BMS AI424-045 96 WEEK RESULTS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL14.4 M. Johnson1, E. DeJesus2, B. Grinsztejn3, C. Rodriguez4, L. Nieto-Cisneros5, J. Coco6, A. Lazzarin7, K. Lichtenstein8, A. Rightmire9, L. Odeshoo9, C. McLaren9, G. Leleu10 All regimens comparably safe and tolerated. At 96 weeks ATV/r demonstrated similar efficacy and significantly improved lipid profile and less diarrhoea vs LPV/r. |
| POSTERS TREATMENT STRATEGIES |
|
| P1 | [P1] NEVIRAPINE, EFAVIRENZ, OR ABACAVIR FOR SIMPLIFICATION OF EFFECTIVE PROTEASE INHIBITOR-BASED ANTIRETROVIRAL THERAPY (THE NEFA STUDY): 3-YEAR RESULTS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P1 Esteban Martinez1, Daniel Podzamczer2, Esteban Ribera3, Pere Domingo4, Jose M. Gatell1 The NEFA study at 3 years showed similar efficacy but less discontinuations due to adverse events and a more favourable lipid profile in the ABC arm. Use of prior suboptimal NRTI therapy was associated with higher virological failure in the ABC arm. |
| P2 | [P2] LONG-TERM EFFICACY AND SAFETY OF TENOFOVIR DISOPROXIL FUMARATE (TDF): A 144-WEEK COMPARISON VERSUS STAVUDINE (D4T) IN ANTIRETROVIRAL-NAÏVE PATIENTS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P2 A. Pozniak1, J. Gallant2, S. Staszewski3, B. Lu4, K. Yale4, M. Miller4, J. Enejosa4, A. Cheng4 Through 144 weeks, the efficacy of combination therapy with TDF was comparable to d4T in antiretroviral-naïve patients. The renal safety profile was similar between the arms. Patients in the TDF arm had a significantly better lipid profile and less lipodystrophy. |
| P3 | [P3] CONCURRENT ADMINISTRATION OF TENOFOVIR (TDF) AND DIDANOSINE (ddI) COMPROMISES IMMUNOLOGIC RECOVERY IN TREATMENT-EXPERIENCED PATIENTS. RESULTS FROM THE TORO STUDIES Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P3 B. Clotet, E. Negredo, A. Bonjoch, R. Paredes Combined use of TDF and ddI resulted in poorer immune recovery over 48 weeks in TORO studies even among those with similar viral suppression (<400 c/ml). |
| P4 | [P4] A SYSTEMATIC REVIEW OF THE EFFICACY OF HAART IN HIV-INFECTED, ANTIRETROVIRAL-NAÏVE PATIENTS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P4 Brian A. Boyle1, Christos J. Paul2, Linda M. Gerber2 The results of the systematic review of these studies, which involved over 5000 patients with a wide range of viral loads and CD4 counts, will be presented and will demonstrate that when the method of analysis and patient variables at entry are accounted for most NNRTI- and PI- based regimens have similar virologic and immunologic performance at the end of 48 weeks of therapy. |
| P5 | [P5] INTERRUPTION/STOPPING HAART AND RISK OF CLINICAL DISEASE PROGRESSION TO AIDS/DEATH IN EuroSIDA Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P5 C. Holkmann-Olsen, A. Mocroft, S. Vella, A. Blaxhult, N. Clumeck, O. Kirk, M. Fisher, C. Katlama, A. Phillips, J. Lundgren Results indicate that risk of AIDS/Death in general increases several-fold upon treatment interruption/stopping. The absolute risk remains closely linked to the latest CD4/HIV-RNA level and was similarly low in patients with CD4 >200/mm3 both in TI- and non-TI-group, supporting further investigation in role of TI for this subgroup by a RCT. |
| P6 | [P6] AN OPEN LABEL STUDY TO DETERMINE THE EFFICACY AND SAFETY OF ENFUVIRTIDE IN PATIENTS CHANGING THERAPY TO AN NRTI SPARING REGIMEN Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P6 David Cooper1, Dominic Dwyer2, Cassy Workman3, Janaki Amin1, John Miller4, Gillian Hales1, Sean Emery1 The strategy of an NRTI sparing regimen plus enfuvirtide provided significant viral suppression and immunologic recovery at week 48 with concomitant improvements in both lean and fat mass. |
| P7 | [P7] TO DETERMINE THE MOST POTENT COMBINATION OF DRUGS TO CONTROL PLASMA VIRUS LOAD AND CD4 CELLS AT PRIMARY HIV INFECTION Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P7 Sarah Fidler, Julie Fox, Christophe Fraser, Norbert Tamm, Simon Dustan, John Clarke, Myra McClure, Jonathan Weber Abstract not reproduced at author's request. |
| P8 | [P8] RANDOMIZED, PLACEBO-CONTROLLED TRIAL OF NANDROLONE DECANOATE IN HIV-INFECTED MEN WITH MILD TO MODERATE WEIGHT LOSS WITH rHGH AS REFERENCE TREATMENT Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P8 Theodorus B.P. Geurts1, Thomas W. Storer2, Linda J. Woodhouse2, Fred Sattler3, Shalender Bhasin2 ND is superior to placebo, and not significantly different from rhGH in its ability to increase LBM in men with HIV-wasting. |
| P9 | [P9] THREE YEARS FOLLOW-UP IN PATIENTS TREATED ACCORDING TO CD4-GUIDED STIs Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P9 F. Maggiolo, G. Gregis, G. Quinzan, D. Ripamonti, L. Ravasio, C. Arici, M. Airoldi, F. Suter HAART can be safely and steadily interrupted in patients who started it with >350 CD4 cells. Patients with a lower CD4 nadir, despite a sustained immune-recovery, have higher risk of rapid decrement of CD4 cells. Optimal timing to start therapy may be re-thought. |
| P10 | [P10] VIROLOGIC EFFICACY OF THREE ONCE-A-DAY HAART REGIMENS. PLANNED INTERIM ANALYSIS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P10 Franco Maggiolo1, Diego Ripamonti1, Guglielmo Migliorino2, Laura Sighinolfi3, Giampietro Gregis1, Giampaolo Quinzan1, Clara Abeli2, Laura Ravasio1, Monica Airoldi1, Fredy Suter1 The studied once-a-day regimens show a high virologic efficacy even in advanced, compromized patients. In the case of virologic failure the resistance mutation pattern is highly influenced by the choice of NRTIs and about half of the patients do not present NNRTI related mutations. OD therapy favor adherence. |
| P11 | [P11] COMPARISON OF ANTIRETROVIRAL AGENTS IN TREATMENT-EXPERIENCED PATIENTS: ENFUVIRTIDE DEMONSTRATES SUPERIOR EFFICACY COMPARED TO OTHER AVAILABLE AGENTS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P11 G. Diego Miralles, Ralph A. DeMasi In triple class experienced pts, the presence of ENF in a regimen resulted in better virological and immunological outcomes than those observed with alternative available agents. |
| P12 | [P12] STUDY DESIGN ISSUES FOR REGISTRATION STUDIES OF ENFUVIRTIDE - A NEW ANTIRETROVIRAL (ARV) CLASS IN ADVANCED HIV INFECTED PATIENTS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P12 J. Chung1, U. Dhingra1, C. Wat2, L. Donatacci1, L. Smiley3, M. Salgo1 The TORO (T20 vs. Optimized Regimen Only) studies successfully incorporated resistance testing for selecting an individualized OB at screening, and a switch study design allowing patients on OB alone to revise their regimen and add ENF, setting a new standard for registration studies in advanced patients. |
| P13 | [P13] HAS POTENCY OF CURRENT HAART REACHED A PLATEAU? RESULTS OF THE MASTER COLLABORATION Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P13 C. Torti1, G. Paraninfo1, F. Maggiolo2, E. Quiros1, A. Patroni1, N. Ladisa3, A. Antinori4, F. Castelnuovo1, G. Rizzardini5, A. Orani6, L. Sighinolfi7, S. Casari1, G. Carosi1 EFV and LPV/r effectiveness was comparable in the mid term in naïve patients. These results suggest that potency is not prejudicial, when HAART is tailored to patient conditions within the frame of current recommendations. On the basis of these results, a prospective randomized study (Sisther) has been initiated. |
| P14 | [P14] VIRO-IMMUNOLOGICAL OUTCOME OF FAILING HEAVILY PRE-TREATED HIV PATIENTS WHO MAINTAINED OR CHANGED THE HIGHLY ACTIVE ANTIRETROVIRAL REGIMEN (HAART). (MASTER-IMPROVE TRIAL) Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P14 P. Nasta1, G. Cocca2, G. Zoboli3, C. Nigro4, M.C. Colombo5, E. Barchiesi6, C. Calzetti7, B. Celesia8, G. Carosi1 A 24 wks MASTER-IMPROVE trial documented a 70% of VL suppression and a CD4+ slight increase in early switch arm. A relatively slow rate of VL increase and a substantially stable CD4 count were shown in Pts remaining on failing HAART. Further analysis on change in resistance mutations pattern are ongoing. |
| P15 | [P15] ANTIRETROVIRAL (ARV) THERAPY IN SPECIAL POPULATIONS: RESPONSE TO LOPINAVIR/RITONAVIR (LPV/R), TENOFOVIR (TDF), AND EMTRICITABINE (FTC) IN ARV-NAÏVE PATIENTS BY GENDER, ETHNICITY, AND HEPATITIS CO-INFECTION STATUS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P15 P. Easterbrook1, S. Green 2, A. Wilken 3, C. Barros 4, P. Domingo 5, C. Naylor 6, J. Hairrell 6, K. Luff 6, M. King 6, S. Brun 6 A regimen of LPV/r dosed QD or BID + TDF + FTC demonstrated similar virologic and immunologic responses regardless of gender, ethnicity, or hepatitis co-infection status. |
| P16 | [P16] EFFICACY OF TENOFOVIR-DF AS INTENSIFICATION OF ZIDOVUDINE/LAMIVUDINE/ABACAVIR FIXED DOSE COMBINATION IN THE TREATMENT OF HIV-POSITIVE PATIENTS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P16 Charles Farthing1, Homayoun Khanlou1, Bill Guyer2 Using TDF as intensification of ZDV/3TC/ABC-FDC represents a viable treatment option. |
| P17 | [P17] EFFECT OF TREATMENT INTERRUPTIONS ON ESTIMATION OF BASELINE ANTIRETROVIRAL SUSCEPTIBILITY AND SUBSEQUENT VIROLOGICAL RESPONSE IN TREATMENT-EXPERIENCED PATIENTS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P17 G.D. Miralles1, S. Deeks2, M. Dolker3, J.A. Thommes3, R.A. DeMasi1 Continuation of ARV in pts failing therapy results in continued virological and immunological effects as compared to interrupting therapy. GT susceptibility is over-estimated for patients OFF ARV at the time RT sampling. These data are inconsistent with the hypothesis that a treatment interruption improves subsequent response to salvage therapy and should be considered when using GT/PT for guiding ARV therapy. |
| P18 | [P18] PRIMARY HIV INFECTION: IS OUTCOME AFTER TREATMENT INTERRUPTION INFLUENCED BY TREATMENT INITIATION? Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P18 Deborah Konopnicki, Stephane De Wit, Coca Necsoi, Kabamba Kabeya, Nathan Clumeck 64% of the p treated early in PHI could subsequently interrupt their T for more than 1 y. Patients in which T had to be reinitiated within 1 y were characterised by a earlier initiation of T and a trend to a lower CD4 cell count at T initiation. Whether this reflects a more severe disease or a blunted immune response needs to be further investigated. |
| P19 | [P19] REDUCTION IN BODY WEIGHT AND CD4 LYMPHOCYTE COUNT WITH SIMPLIFICATION REGIMENS INCLUDING TENOFOVIR AND DIDANOSINE (TD). A SCHEME TO AVOID? Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P19 Rosario Palacios, Jesús Santos, Mercedes González, Josefa Ruiz, Manuel Márquez Simplification with TD and a NNRTI may lead to a drop in body weight and CD4 lymphocyte count. Weight loss is greater in patients with a lower CD4 nadir. The appropriateness of this regimen for simplification merits further evaluation. |
| P20 | [P20] DISCONTINUATION OF HAART: PREDICTIVE VALUE OF AND IMPACT ON IMMUNOLOGICAL CHANGES Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P20 Giota Touloumi1, Nikos Pantazis1, Heide A. Stirnadel2, Kholoud Porter3 In this large study, a substantial number of subjects discontinued HAART at 2 years. Further research is needed to investigate the reasons for which women are more likely to have a TD. Given that CD4 cell loss is greater in individuals with low pre-HAART nadir CD4 cell counts, caution is suggested when TD is considered in such subjects. |
| P21 | [P21] ATAZANAVIR/RITONAVIR/SAQUINAVIR WITHOUT ANY OTHER ANTIRETROVIRAL DRUGS IN PROTEASE INHIBITOR EXPERIENCED PATIENTS WITH NO REVERSE TRANSCRIPTASE INHIBITOR OPTIONS: A 24 WEEK COHORT ANALYSIS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P21 C. Rottmann1, B. Dauer1, N. v. Hentig1, M. Kurowski2, M. Stuermer1, S. Staszewski1 ATV/r + SQV therapy may be an option as salvage therapy for patients with RTI resistance or toxicity but may not be suitable for patients with heavy PI resistance and very low CD4 nadir. |
| P22 | [P22] CLINICAL EXPERIENCE WITH ATAZANAVIR Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P22 Paul Holmes, Paul Randell, Mark Bower, Brian Gazzard, Mark Nelson ATZ may be successfully utilized in individuals requiring switch of antiretroviral agents, in individuals who are PI naïve, and in those who are PI experienced. |
| P23 | [P23] EFFICACY AND TOLERANCE OF LOPINAVIR/RITONAVIR IN CLINICAL PRACTICE: AN OBSERVATIONAL PROSPECTIVE COHORT OF 1278 PATIENTS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P23 Alain Lafeuillade1, Isabelle Cohen-Codar2, Michel Dupon3, Jean-Michel Livrozet4, Laurence Morand-Joubert5, François André Allaert6 This study shows a good efficacy of LPV/r-containing regimens and modest effects on lipid levels: early increase and no additional drug intervention generally required. |
| P24 | [P24] DOUBLE BOOSTED PROTEASE INHIBITORS IN SALVAGE THERAPY Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P24 Bower, B, Gazzard, M. Nelson LPV/SQV is the preferred double boosted PI combination. The pharmacokinetic interaction between LPV and APV with both drug levels reduced may be a reason for these individuals to perform less well. LPV/SQV regimens are not recommended in patients with UPAMs or >4 PI mutations. LPV/APV regimens are not recommended unless careful TDM is performed. |
| P25 | [P25] EARLY RESPONSE TO A ONCE-DAILY REGIMEN CONSISTING OF BOOSTED ATAZANAVIR PLUS TWO NUCLEOSIDE/NUCLEOTIDE REVERSE TRANSCRIPTASE INHIBITORS IN PROTEASE INHIBITOR-EXPERIENCED PATIENTS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P25 B. Dauer1, M. Stuermer1, G. Nisius1, A. Mueller1, M. Kurowski2, T. Lutz3, S. Klauke4, S. Staszewski1 In pts with >400 copies (n=6), ATV Cmin was a median 538 ng/ml (range 319-1340); RTV Cmin was a median 108 (range 19-197). Despite low plasma concentrations, early virologic response may be achieved with once daily ATV/r plus 2 NRTIs. |
| P26 | [P26] LOPINAVIR/R OR EFAVIRENZ PLUS TWO NRTI AS FIRST-LINE ANTIRETROVIRAL THERAPY: A NON RANDOMISED COMPARISON Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P26 A. De Luca1, A. Cozzi Lepri2, A. Antinori3, M. Zaccarelli 3, A. D'Arminio 4, M. Bongiovanni 4, S. Di Giambenedetto 1, D. Zinzi 3, P. Cicconi 4, F. Resta 5, B. Grisorio 6, S. D'Elia 7, R. Cauda 1 No differences in terms of tolerability and response to LPV or EFV could be detected. Although our study was not randomised, the results may reflect conditions under which drugs were used as well as real differences in potency/induced toxicity. |
| P27 | [P27] COST EFFECTIVENESS OF LOPINAVIR/R (LPV/R) VS. ATAZANAVIR IN TREATING ANTIRETROVIRAL-NAÏVE PATIENTS: MODELING THE COMBINED EFFECTS OF HIV AND HEART DISEASE Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P27 K.N. Simpson1, M.P. Luo2, E. Chumney1, J. Macyck2, M. King1, S. Brun1, T. Ashraf1 The effect of LPV/r on long-term CHD risk was minimal compared to the increased risk of AIDS/death projected for ATV. The cost of lipid-lowering drugs and treatment for CHD was insignificant compared to the overall cost savings from LPV/r therapy. The choice of initial HAART regimen should be based on a regimen's expected efficacy and durability. |
| P28 | [P28] LOPINAVIR/RITONAVIR (LPV/R)-BASED THERAPY IN ANTIRETROVIRAL (ARV)-NAÏVE, HIV-INFECTED PATIENTS: 6-YEAR FOLLOW-UP OF STUDY 720 Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P28 R.M. Gulick1, B. da Silva2, F. McMillan2, C. Benson3, A.C. White4, M. Glesby1, M. Thompson5, M. Albrecht6, P. Wolfe7, R. Murphy8, H. Kessler9, J. Eron10, C. Hicks11, K.R. King2, D. Calhoun2, N. Braun2, M. King2, S. Brun2 LPV/r-based therapy demonstrated sustained ARV activity and was generally well tolerated in ARV-naïve pts through 6 years of therapy. |
| P29 | [P29] EFAVIRENZ VERSUS LOPINAVIR/RITONAVIR IN AN ANTIRETROVIRAL COMBINATION WITH A BACKBONE REGIMEN OF TWO NRTIs Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P29 Periklis N. Panagopoulos, Sotirios Tsiodras, Garifalia Poulakou, Ioannis Katsarolis, Antonios Papadopoulos, Anastasia Antoniadou EFV as well as LOP/rit based HAART regimens accomplished an equally substantial effect on immunological and virological parameters in naïve patients. We cannot definitively exclude superiority of one arm in experienced patients since LOP/rit group had worse immunological status. |
| P30 | [P30] DATA FROM THE CLARE (CORE CENTER LOPINAVIR/R (LPV/R) ANTI-RETROVIRAL EFFECTIVENESS) COHORT Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P30 R. Sherer4, O.M. Adeyemi1, E. Simeone1, S. Shott1, J. Despotes1, M. Lee1, J. Tschampa3 Describe the efficacy of LPV/r regimens in an urban clinic. A prospective observational study. 10/02 -10/03, HIV+ pts on LPV/r enrolled. At entry (E) and week 4-12 and week 13-36 visits, labs and anthropometrics were done. 120 HIV+ pts on LPV/r for a med. of 7 (0-41) mths enrolled. |
| P31 | [P31] RESPONSE TO LOPINAVIR/RITONAVIR-BASED HAART AND ITS DEPENDENCE ON PRIOR ARV EXPERIENCE: 24-WEEK INTERIM ANALYSIS (VIHVIR+ STUDY) Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P31 Angel Burgos1, Esther Cabrero1 Since lopinavir / ritonavir (LPV/r) was approved for treatment of HIV in Spain (Aug 01) many supported its use as rescue for heavily pretreated patients (PT) while others supported its use in less experienced PT. |
| P32 | [P32] USE OF LPV/R IN HIV-INFECTED PATIENTS FAILING A FIRST PROTEASE-INHIBITORS-CONTAINING HAART Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P32 Marco Bongiovanni1, Teresa Bini1, Antonio Di Biagio2, Paola Meraviglia3, Federica Tordato1, Paola Cicconi1, Antonella d'Arminio Monforte1 Among 15 patients not reaching HIV-RNA<50 cp/ml, 5 had ?5 mutations in the protease region which reduce susceptibility to LPV/r (1 discontinued LPV/r for gastrointestinal intolerance), 5 had no mutations (2 discontinued LPV/r for gastrointestinal intolerance) and 5 had ≥6 mutations (all discontinued LPV/r); all pts discontinuing LPV/r do not achieve HIV-RNA <50 cp/ml throughout the study. LPV/r showed to be highly effective and well tolerated in HIV pts failing a first PI-HAART. |
| P33 | [P33] VIROLOGICAL AND IMMUNOLOGICAL OUTCOME OF STAVUDINE (D4T) AND TENOFOVIR (TDF) COMBINATION AS NRTI BACKBONE IN PATIENTS WITH HIGH RATE OF TIMIDYNIC ANALOGUE MUTATIONS(TAM) Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P33 Paola Nasta, Giuseppe Paraninfo, Andrea Patroni, Silvia Costarelli, Giampiero Carosi Although an high number of TAM, d4T+TDF combination containing HAART regimens seems to be effective in heavily pre-treated Pts. |
| P34 | [P34] USE OF ANTIRETROVIRAL DRUGS IN CORRECTIONAL FACILITIES Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P34 E. Pontali, L. Papa, F. Toscanini, A. Levati, C. Lugani, R. Papatola, M. Zaccardi, F. Ferrari HIV+ prisoners can receive adequate ART in CFs. However, differences exist in drug use between in and out of CFs (NVP > EFV; frequent triple NRTIs) and in the use of double NRTIs combinations. Such differences can be justified by the specific characteristics of the HIV+ prison population. Furthermore, in consideration of the wide variety of employed regimens and of the turn-over of prisoners (to and from freedom), the need of a good prison pharmaceutical service must be underscored to guarantee the proper and regular procurement, and the availability (for new entries from freedom, transfers) of antiretroviral drugs. |
| P35 | [P35] USE OF A TRIPLE NUCLEOSIDE ANTIRETROVIRAL REGIMEN (TRIZIVIR™) IN CLINICAL PRACTICE: A RETROSPECTIVE ANALYSIS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P35 Ines V. Pinto, Anabela S. Marques, Vanda Castro, Jose Vera Simplification with TZV in pts with undetectable viremia provides continued virological suppression. When TZV is used in naïve pts, our results show that the majority of pts with baseline VL >30.000 c/ml fail virologically. |
| P36 | [P36] ABACAVIR, LAMIVUDINE AND ZIDOVUDINE (ALZ) IN ANTIRETROVIRAL-NAÏVE HIV-INFECTED PATIENTS WITH PROFOUND IMMUNOSUPPRESSION (CD4+ CELLS < 100/mm³: A MULTICENTER OBSERVATIONAL STUDY Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P36 Juan Berenguer1, Pérez-Elas María Jesus2, Resino Salvador1, Knobel Hernando3, Rivas-González Pedro4, José María Gatell5 In this large cohort of naïve HIV+ Pt with CD4+ < 100/mm³ and frequent prior ADC, the triple-NRTI regimen of ALZ was relatively well tolerated and effective. Poor adherence and baseline VL were factors independently associated with VF. |
| P37 | [P37] SOME TRIPLE NUCLEOSIDE REGIMENS MAY BE A GOOD TREATMENT ALTERNATIVE IN A SUBSET OF HIV+ PATIENTS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P37 Ivana Maida1, Marina Nunez2, Paloma Gil2, Juan Gonzalez-Lahoz2, Vicente Soriano2 The limited potency of TZV must be balanced with the benefit derived from its convenience. Our data suggest that TZV might be a valid alternative for some HIV populations, such as those at higher risk for liver toxicity and/or poor drug compliance and/or with a need for simple and free-from-interactions regimens. |
| P38 | [P38] RETROSPECTIVE EVALUATION OF NRTI-ONLY HAART REGIMENS CONTAINING TDF Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P38 James D. Scott, Peter R. Wolfe2, Robert K. Bolan3, Ryan Quist1, Bill Guyer4 Virologic response of patients given NOR was comparable to those given NNPIR. However, there was a selection bias in favor of the NOR group towards undetectable baseline VLs. Development of K65R was rare. |
| P39 | [P39] HEAD-TO-HEAD COMPARISON OF THE ONLY TWO FIRST-LINE ANTI-HIV REGIMENS RECOMMENDED FOR ANTIRETROVIRAL NAÏVE PATIENTS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P39 Roberto Manfredi, Leonardo Calza, Francesco Chiodo International guidelines propose either L or E as equivalent first-line therapy of HIV disease, but in absence of randomized data the regimen selection should consider the initial immunologic-disease status. Given the different cost of these 2 therapeutic approaches, appropriate pharmacoeconomic studies are also needed. |
| P40 | [P40] EVALUATION OF IMMUNOVIROLOGICAL OUTCOME AND SAFETY OF ATAZANAVIR CONTAINING HAART (EAP) Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P40 Federica Tordato1, Elisabetta Chiesa1, Amedeo Capetti2, Antonio Di Biagio5, Clara Abeli4, Stefania Merli3, Marco Bongiovanni1, Roberto Rossotti1, Antonella d'Arminio Monforte1, Teresa Bini1 In our study ATV containing HAART was well tolerated in advanced HIV pts. Use of ATV seems associated with a moderate reduction of VL. |
| P41 | [P41] CLINICAL EXPERIENCE WITH RITONAVIR BOOSTED ATAZANAVIR Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P41 Mark Pakianathan1, Waleed Hamad1, Joanna Taylor1, Macky Natha2, Helen Pritchitt1, Brett Marrett1, Tariq Sadiq1, Mark Wansborough Jones1 ATZ/r appears safe and effective in the management of treatment experienced patients including those switching from an effective PI contianing regimen. Longer term follow up is required to ascertain durability. |
| P42 | [P42] ATAZANAVIR USE IN THE GERMAN EARLY ACCESS PROGRAM Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P42 A. Stoehr, K. Graefe, A. Plettenberg Switch to an ATV containing regimen in this highly heterogeneous group of patients showed good immunologic and favourable virologic results. Chlesterol and glucose remained stable, initially elevated triglycerides decreased to normal. Most patients showed the typical drug related side effect hyperbilirubinema without liver toxicity, with one patient switched to unboosted ATV. Other side effects were rare, the acceptance was good. For some "hard to treat" patients qd ATV containing ART was the first effective treatment. |
| P43 | [P43] LONG-TERM FOLLOW-UP OF A COHORT OF ANTIRETROVIRAL EXPERIENCED HIV-1 INFECTED PATIENTS SIMPLIFIED TO TRIZIVIR Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P43 Andrea Holmes, Laura McCullagh, Colm Bergin, Fiona Mulcahy Following discussion of ACTG 5095 at IAS in 2003, use of AZT/3TC/ABC has been discouraged. Our experience is of a low rate of virological failure. |
| P44 | [P44] PATIENT SATISFACTION WITH ABACAVIR (ABC)-LAMIVUDINE (3TC) FIXED DOSE COMBINATION (FDC) TABLET ONCE DAILY (QD) COMPARED WITH ABC AND 3TC TWICE DAILY (BID) IN HIV-1 INFECTED PATIENTS (ESS30008) Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P44 Maria Watson1, Christina Hill-Zabala1, Nestor Sosa2, Edwin DeJesus3, Allison Florance1 Compared with ABC+3TC BID, satisfaction with tx convenience was significantly improved in pts on ABC/3TC FDC QD. Symmetrical dosing regimens seem to enhance satisfaction. |
| P45 | [P45] ABACAVIR + LAMIVUDINE (ABC/3TC) FIXED DOSE COMBINATION (FDC) ONCE DAILY (QD) COMPARED TO ABC+3TC TWICE DAILY (BID) IN HIV-1 INFECTED SUBJECTS (ESS30008) Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P45 Christina Hill-Zabala2,Nestor Sosa1, Edwin DeJesus3, Gisela Herrera4, Allison Florance2, Judy Johnson2, Maria Watson2, Mark Shaefer2 24-wk interim analysis established ABC/3TC FDC QD as noninferior to ABC+3TC BID in a NNRTI or PI-containing regimen. A nucleoside backbone of ABC+3TC administered QD or BID is effective, durable, and well-tolerated. |
| P46 | [P46] PILOT STUDY OF ONCE-DAILY (QD) QUAD THERAPY WITH TRIZIVIR (ABC/3TC/ZDV) AND EFAVIRENZ (EFV) Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P46 Peter Ruane1, Joseph Lang2, Edwin DeJesus3, Daniel Berger4, Robin Dretler5, Allan Rodriguez6, Doug Ward7, Michael Lim8, Qiming Liao8, Sunila Reddy8, Marty StClair8, Mark Shaefer8 In this pilot study of subjects suppressed on TZV BID + EFV, switching to TZV QD + EFV (3 tablets QD) was associated with similar rates of virologic suppression and tolerability, compared to continued TZV BID + EFV. |
| P47 | [P47] EFFICACY, SAFETY, ADHERENCE AND PHARMACOKINETICS OF THE SIMPLIFICATION TO A ONCE DAILY REGIMEN WITH NNRTIS IN PATIENTS PREVIOUSLY RECEIVING ANTIRETROVIRAL THERAPY TWICE DAILY Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P47 Javier Moya, Jose L. Casado, Lidia Aranzabal, Ana Marin, Ana Moreno, Santiago Moreno The use of a QD regimen with ddI+3tC+NNRTIs is useful, well-tolerated, and increase adherence, even in patients receiving a BID regimen. Plasma trough levels of nevirapine support its use in a QD regimen. |
| P48 | [P48] ONCE DAILY TENOFOVIR, LAMIVUDINE AND EFAVIRENZ IN PREVIOUSLY SUPPRESSED HIV-1 INFECTED PATIENTS. 12 WEEKS PRELIMINARY DATA FROM THE SEINORTE COHORT Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P48 J. Arrizabalaga1, K. Aguirrebengoa2, A. Chocarro3, M.J. Munoz4, J.A. Oteo5, S. Echevarria6, P. Labarga7, C. Farinas6, G. Peralta8, J. Camino1, P. Ferrer9 ARV treatment simplification to a once daily regimen containing TDF, 3TC and EFV seems to be safe, well-tolerated and virologically and immunologically effective. |
| P49 | [P49] EFFICACY OF A ONCE DAILY (QD) REGIMEN OF NEVIRAPINE (NVP), LAMIVUDINE (3TC) AND TENOFOVIR (TDF) IN TREATMENT-NAÏVE HIV INFECTED PATIENTS: A PILOT STUDY Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P49 William Towner, Hai Linh Kerrigan, Marc LaRiviere, Townson Tsai, Jim Nomura, Joseph Chang, Erika Marmolejo At 24 weeks of therapy, only 43% of antiretroviral naïve pts given NVP/3TC/TDF as QD therapy achieved a VL < 75 c/ml. Despite good adherence, those with BL VL > 100,000 c/ml were most prone to failure, largely due to NVP resistance (Y181C). |
| P50 | [P50] EXPERIENCE OF COMBINATION HAART WITH 3TC+DDI+EFV IN A SIMPLIFIED QD REGIMEN AND IN PATIENTS WITH IMMUNOVIROLOGIC FAILURE DUE TO LACK OF ADHERENCE TO MORE COMPLEX HAART REGIMENS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P50 Francisco J. Vera, Josefina Garcia, Onofre J. Martinez, Rafael Vilaplana, Trinitario Sanchez, Jose A. Garcia During follow-up, the combination 3TC-DDI-EFV proved to be a highly efficacious and well tolerated in patients with QD simplification regimen. In patients with poor adherence, other strategies must be considered to provide best results in terms of adherence and efficacy. |
| P51 | [P51] ONCE-DAILY COMBINATION THERAPY WITH LAMIVUDINE, TENOFOVIR AND NEVIRAPINE IN NAÏVE AND PRETREATED HIV1-INFECTED PATIENTS: 48-WEEK RESULTS OF THE READMUNE STUDY Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P51 Laurent Roudiere The once-daily combination of 3TC, TDF and NVP could be a new option for naive HIV-infected patients and for treatment simplification in pretreated patients. In case of virologic non response or failure, the low genetic barrier of the 3 drugs led to the rapid appearance of mutations associated with high level of resistance. |
| P52 | [P52] SAFETY AND PHARMACOKINETICS OF THE USE OF NEVIRAPINE ONCE DAILY IN HIV-INFECTED PATIENTS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P52 Jose L. Casado, Javier Moya, Lidia Aranzabal, Ana Marin, Ana Moreno, Santiago Moreno Nevirapine 400 mg once daily shows a similar pharmacokinetic profile to the use of 200 mg twice daily, and it could improve the adherence. The rate of rash or hepatotoxicity was not higher than expected, and was related to alcohol abuse and previous liver disease. |
| P53 | [P53] ONCE-DAILY BOOSTED DUAL PROTEASE INHIBITOR AS SALVAGE THERAPY IN HEAVILY PRETREATED HIV-INFECTED PATIENTS. A PILOT STUDY Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P53 Luigia Elzi, Hans H. Hirsch, Julian Mettler, Monika Blasko, Manuel Battegay Our preliminary results suggest that boosted dual PI regimen given OD (LPV/r plus IDV), possibly as DOT, may be an important salvage therapy for selected pts with poor adherence and no NRTI/NNRTI options. |
| P54 | [P54] CLINICAL AND PSYCHOLOGICAL IMPACT OF PROLONGED NELFINAVIR-CONTAINING REGIMENS. PSIRENE STUDY Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P54 Carmina R. Fumaz, Jose Lopez Aldeguer, Fernando Lozano, Hernando Knobel, Pompeyo Viciana, Bonaventura Clotet A correlation (p<0.05) between higher time on tt and low levels of D and F was found. After 72 w a NFV-containing regimen maintains viral suppression, stable QOL and high ADH. ES improved, especially D and F. A relative complex tt with virological success and well-tolerated could be mantained for prolonged time. |
| P55 | [P55] LOWERING STAVUDINE DOSAGES DOES NOT COMPROMISE ANTI-VIRAL EFFICACY IN HIV-1 INFECTED PATIENTS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P55 Myriam Kirstetter2, Cyrille Delpierre1, Lise Cuzin1, Muriel Alvarez1, Sarah Khatibi1, Eric Bonnet1, Martine Obadia1, Bruno Marchou1, Patrice Massip1 Reduced-dose stavudine containing regimens maintained virologic suppression and CD4 increase on a 12-months period. Further studies are needed to assess the improvement of the long term toxicities. |
| P56 | [P56] DEVELOPING A COMPREHENSIVE COMMUNITY PREPAREDNESS FOR ARVS TREATMENT IN UGANDA Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P56 Matovu Umar Community preparedness for ARV'S will mean having the necessary information, knowledge, skills and materials including regular, uninterrupted supplies of Medicine and diagnostics. |
| P57 | [P57] A COMPARISON OF SIX ANTIVIRAL REGIMENS IN DRUG-NAÏVE PATIENTS (THE CRIPPLED STUDY) Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P57 Giuliano Rizzardini1, Daria Trabattoni2, Amedeo Capetti 3, Marco Migliorino1, Gianmarco Vigevani3, Mario Clerici2 These preliminary results suggest that ABC-containing regimens are associated with the highest CD4 counts and the strongest suppression of HIV plasma viremia, whereas boosterized PI-containing regimens have a more robust effect on functional immune parameters after 6 months from starting thepaphy in drug-naïve patients. |
| P58 | [P58] TOLERABILITY, VIROLOGIC AND IMMUNOLOGIC ACTIVITY OF EFAVIRENZ IN PRE-TREATED LONG TERM HIV-INFECTED PATIENTS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P58 Axel Adam1, Carl K. Schewe1, Thomas Meier2, Hauri Goey1, Lutwin Weitner1 In clinical practice Efavirenz exhibits strong antiviral and immunologic activity comparable to controlled clinical trials even in pre-treated long term HIV-infected patients with good tolerability and a low rate of virologic failure. |
| P59 | [P59] ARAMIS: AN OBSERVATIONAL PROSPECTIVE STUDY OF PATIENTS RECEIVING A ONCE DAILY ANTIRETROVIRAL REGIMEN. FIRST DATA ANALYSIS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P59 R. Landman1, Y. Mouton2, I. Ravaux3, P. de Truchis4, A. Smith1 These first data confirm the high satisfaction index and adherence of pts during the first months of a QD antiretroviral regimen. |
| P60 | [P60] IMPROVED AND DURABLE CONTROL OF HIV-VIRAEMIA AMONG PATIENTS RECEIVING HIGHLY ACTIVE ANTIRETROVIRAL THERAPY FROM 1998 TO 2003 Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P60 Laura Lehtola-Vanhanen, Pia Kivelä Veli-Jukka Anttila, Jussi Sutinen, Matti Ristola HAART has changed the lives of HIV-infected patients dramatically, but it can not be achieved without good adherence. We have shown here that long lasting treatment goals wtih HAART can be achieved in more than 85% of patients. This improved and durable virological succes can be obtained by a well-structured clinical system taking care of our patients and by emphasising adherence as the most important tool of achieving our goals of therapy. |
| P61 | [P61] THE EFFICIENCY OF SHORT COURSE OF HAART IN PATIENTS WITH PRIMARY HIV-INFECTION Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P61 Andrey V. Miroshnichenko, Alexey V. Kravchenko For patients with primary HIV-infection who initially have VL more than 100,000 copies/ml and CD4 cell numbers less than 350 cells/ml, the course of HAART should be prolonged up to 6 or even 12 months. |
| P62 | [P62] EFAVIRENZ AND NEVIRAPINE IN CLINICAL PRACTICE. A RETROSPECTIVE STUDY IN A COHORT OF NAÏVE AND EXPERIENCED SUBJECTS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P62 Benedetto M. Celesia, Luciano Nigro, Alda Ragusa, Maria T. Mughini, Filippo Palermo, Fabio Bisicchia, Rosario Russo For patients with primary HIV-infection who initially have VL more than 100,000 copies/ml and CD4 cell numbers < 350 cells/ml, the course of HAART should be prolonged up to 6 or even 12 months. |
| P63 | [P63] EFFICACY OF EFAVIRENZ VS. NEVIRAPINE WITH A BACKBONE OF TWO NRTIS. RESULTS AT 48 WEEKS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P63 Jorge M. Contarelli, Lucila I. Massera, Gabriela E. Alberich, Martha G. Michaan Restoration of CD4 cell was 64% and 215% for EFV, and 72% and 169% for NVP respectively. (p = 0.07). At 12 month 85,7% in the arm on EFV and 71,0% on NVP remain undetectable (p = 0.6). Adverse events were seen in 16,0% with EFV and 8,3% with NVP. The rate of discontinuation were 3,8% with NVP and 4,67% with EFV. Both NNRTI have similar efficacy and durability at 48 weeks. Adverse events were higher with EFV but the rate of discontinuation or withdraw treatment were similar in both arms. |
| P64 | [P64] SUPERVISED TREATMENT INTERRUPTION (STI) IN CHRONICALLY HIV INFECTED PATIENTS WITH LONG TERM WELL CONTROLLED VIRAL LOAD UNDER ANTIVIRAL THERAPY Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P64 Philippe A.L. Henrivaux1, Benoit Kabamba2, Yvette Fairon3, Patrick Goubau2 STI in HIV patients with very low viral load on ART, under carefull clinical and biological control, remained safe in our experience. Different profiles of evolution of CD4 cells and viral loads are observed during STI. Some patients benefit from a long treatment interruption avoiding side effects of continuous drug exposure. Therefore, it would be interesting to predict the evolution during STI. |
| P65 | [P65] MULTICENTER STUDY OF AN INDINAVIR/LOPINAVIR BASED REGIMEN IN SALVAGE THERAPY OF NUCLEOSIDE-ANALOGUES EXPERIENCED PATIENTS (MILESTONE) Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P65 E. Lauenroth-Mai1, H. Gellermann2, S. Fenske2, W. Mondorf3 The combination of IDV and LPV/r provided a robust virological and immunological response in multiple treatment-experienced subjects that was maintained throughout the observation period of approximately one year. |
| P66 | [P66] DIFFERENT IMPACT OF EFFICACY, TOXICITY AND CONVENIENCE ON THE PRESCRIPTION OF ANTIRETROVIRAL DRUGS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P66 Vicente Soriano,Inmaculada Jimenez-Nacher, Carmen de Mendoza, Benito Garcia-Diaz Trends in ARV prescription reflect the priorities perceived by physicians at any given time point. While potency of PIs seem to drove prescriptions before 1999, the awareness of their potential toxicities pushed NNRTIs since then. More recently, convenience seems to have emerged as a new priority, which has favoured the prescription of TZV or TDF. |
| HIV MANAGEMENT IN RESOURCE-POOR SETTINGS |
|
| P67 | [P67] HIV-PATIENTS ACROSS EUROPE: REGIONAL DIFFERENCES IN PATIENT CHARACTERISTICS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P67 D. Podlekareva, W. Bannister, L. Viksna, A. Mocroft, B. Knysz, P. Reiss, N. Chentsova, D. Duiculescu, J.D. Lundgren, O. Kirk These results reflect substantial regional differences in demographic and clinical characteristics of HIV-pts across Europe and demonstrate the more recent epidemic in CE and EE. The implications of the limited usage of HAART in EE require continuous follow-up. The high percentage of AIDS pts in CE and EE who have TB is a special concern, as high prevalence of multi-resistent mycobacteria have been reported in these regions. |
| P68 | [P68] TWO-YEAR OUTCOMES OF THE FIRST PUBLIC-PRIVATE COMMUNITY ANTIRETROVIRAL PROGRAMME IN CAPE TOWN , SOUTH AFRICA Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P68 Catherine Orrell, Linda-Gail Bekker, Motasim Badri, Robin Wood In patients with advanced HIV the initial regimen of d4T, 3TC and NVP or EFV is well tolerated. This community cohort displays high levels of adherence and viral suppression. |
| P69 | [P69] EVALUATION OF HIV MANAGEMENT IN PREGNANT WOMEN IN FOUR CENTRES IN NIGERIA Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P69 Chinazo O. Nwashili1, Uzoma O. Azubike2, Grant-Isibor I. Irene3 Poverty, ignorance and fear of stigmatization are huge obstacles in HIV management in resource-poor settings. Although drugs were without cost for participants 75% of HIV positive women refused to participate for fear of stigmatization. Use of Nevirapine was more acceptable because of the dosing. Bi and tritherapy was not readily available because of cost. Monotherapy will increase the chances of resistance developing in resource-poor setting which will eventually become a problem if not addressed. |
| P70 | [P70] COMMUNITY TREATMENT SUPPORT IN A RESOURCE LIMITED SETTING: THE USE OF DOT-HAART Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P70 John A. Idoko1, Oche O. Agbaji1, Patricia O. Agaba1, Jean Louis A. Sankale2, Phyllis M. Kanki2 The virological and immunological responses to treatment at 6 months demonstrate that in resource limited settings, the use of sustained adherence education and family and community members to implement DOT-HAART can greatly enhance adherence to antiretroviral therapy and therefore ensure a durable virologic response. |
| P71 | [P71] TB A KEY DETERMINANT OF ART SUCCESS IN INDIAN SETTING: A MULTICENTRIC STUDY Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P71 Dattatray G. Saple1, Satish B. Vaidya1, Shailendra N. Sawleshwarkar 1, Ravi Vadrevu2, Ved P. Pandey3 Choice of HAART regimen in absence of TB does not significantly affect success. Atypical TB is more likely to experience ART failure. ART success rates with Rifampicin based ATT are likely to be similar in typical and atypical TB presentations. |
| P72 | [P72] HEMATOLOGIC COMPLICATIONS IN THE ERA OF HAART Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P72 S.N. Pujari, A. Patel2, S. Bhagat1, J. Patel2, K. Patel2, S. Katke1 Hematologic complications are common in patients with clinical AIDS. Macrocytosis with AZT/d4T can serve as one of the markers for assessing adherence. HAART is associated with lower prevalence of hematologic complications in spite AZT use. However CD4<200 is a major risk factor for development of hematologic complications. |
| P73 | [P73] TRAINING 23,000 HEALTH CARE WORKERS IN HUBEI PROVINCE, PEOPLES REPUBLIC OF CHINA Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P73 Renslow Sherer, Caroline Teter1, Gui Xien2, Bonnie Shen1, Diana Liu Ping1 Large scale HIV training in China is feasible. Local health leadership, a strong university partner, a revered local HIV expert, and regional ownership are invaluable. |
| P74 | [P74] HIV INFECTION AMONG PREGNANT WOMEN AND NEWBORN AND ANTIRETROVIRAL CHEMOPREVENTION Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P74 Elena N. Vinogradova1, Alexey A. Iakovlev2, Eugene F. Senchik1, Aza G. Rakhmanova2 Infants from HIV positive mothers without prenatal care need special medical and social support. We are discussing the possibility to have a special unit for abondened infants from HIV positive mothers. |
| P75 | [P75] THE 'REAL' ANTI RETROVIRAL THERAPY EXPERIENCE OF RESOURCE POOR SETTINGS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P75 Milind Bhrushundi1, Ramesh Mundle1, Radha Munje2, Dinesh Agrawal3 ART coverage was 18.90%. Most of the patients opted for the cheaper regimens. Adherence was more with the regimen less than Rs2000 per month. This is again not a real resource poor settings as those who could afford the consultation charges have attended the OPD. The really real resource poor setting may be still different. |
| P76 | [P76] PROVISION OF ANTI-RETROVIRAL THERAPY IN A CLINICAL COHORT IN RURAL SW UGANDA Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P76 Lieve Van der Paal, Billy N. Mayanja, Joseph O. Mugisha, Leigh Anne Shafer, Heiner Grosskurth In spite of starting ART with relatively advanced HIV disease (WHO stage 3 or 4), most patients improved clinically as well as immunologically. In this rural African setting, mortality is highest in patients with CD4 counts below 50 cells/μl. Almost 20% of patients had to switch drugs after starting treatment. This indicates the need for frequent monitoring during the first months on ART. |
| P77 | [P77] FREE ART INITIATIVE - CHALLENGES IN A DEVELOPING COUNTRY Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P77 Alaka K. Deshpande, Anshuman Malviya The experience from planning, procurement, implementation and evaluation will be presented. |
| P78 | [P78] PRELIMINARY CLINICAL EXPERIENCE OF 3 DRUG ANTIRETROVIRAL THERAPY IN 68 PERSONS WITH HIV/AIDS FROM MUMBAI , INDIA Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P78 Mahendra M. Kura HAART therapy under careful supervision is beneficial in reducing morbidity improving quality of life free of OI's however mortality continues.Cost and compliance are major hurdles in the Indian set up. Long term studies still needed. |
| P79 | [P79] EXPERIENCE OF ANTIRETRIVIRAL DRUG USE IN A ROUTINE CLINICAL SETTING IN KAMPALA , UGANDA Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P79 Doris Mwesigire A good immunological and clinical response to ART in a routine clinical setting was found. Development of side effects and longer duration on ART are associated with non-compliance which reduces immunological response strategies to maintain a high level of compliance with ART, including intensive patient education are important. |
| P80 | [P80] EPIDEMIOLOGIC AND CLINICAL ASPECTS OF HIV INFECTION AMONG FOREIGN WORKERS LIVING IN TEL AVIV (ISRAEL) Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P80 Ben Werner, Israel Yust, Nurit Vardinon, Elizabetta Mardkhah, Zivia Werner, Michael Burke Various endeavours, including our free testing, reduced medical and lab. fees and providing available drugs, have improved overall prognosis in this high-risk group somewhat and reduced vertical transmission remarkably. Nevertheless, much more remains to be done to combat the HIV epidemic and achieve Western standards in this subpopulation. |
| P81 | [P81] EARLY PI TO NNRTI SWITCH IN LATE HIV DISEASE: A COST EFFECTIVE LONG TERM TREATMENT PLAN IN RESOURCE LIMITED SETTINGS Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P81 Kiran N. Katkar Early PI to NNRTI switch appears effective feasible option in settings where costs and treatment simplifications over-ride in determining ART success rates. Benefits need to be confirmed in larger RTCs with longer longitudinal follow-up with monitoring pVL and resistance testing. |
| P82 | [P82] GEDE FOUNDATION PARTNERSHIP PROGRAMME TO IMPROVE HEALTH INSTITUTIONS AND STATE GOVERNMENTS' CARE AND PREVENTION EFFORTS FOR SLOWING HIV/AIDS SPREAD Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P82 A. Olusola, M. Njoku, H. Khamofu, S. Agwale This observation demonstrates the dire need of ARVs drugs across Nigeria. It also confirms the urgent need of improved access to ART by People Living with HIV/AIDS (PLWHAs). It concludes with a call for many more people to team up with the government to make ARVs more accessible and available. |
| P83 | [P83] INFORMATION TECHNOLOGY USE IN HIV/AIDS TREATMENT AND CARE: MAJOR ISSUES AND CONCERN IN NIGERIA Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P83 A.O. Adeyemi, M.H. Ayegboyin There is a need to lay a proper infrastructure for Electronic Medical Records in all our hospitals involved in HIV/AIDS treatment and care. There is a need to set up rural and urban telehealth facilities that will re-train or update our providers in HIV management. Besides, the potentials of Telehealth should be maximally explored in Nigeria through the creation of Telehealth training centers in areas with highest HIV prevalence. There is also a need to introduce handheld computer or personal digital assistants (PDA) to assist providers. |
| P84 | [P84] DISCLOSURE OF SERO-STATUS AS A KEY DETERMINANT OF SUCCESSFUL DRUG THERAPY (TASO MBARARA EXPERIENCE) Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. P84 |