AEGiS-13IAC: Effect of Change from TID to BID Nelfinavir (NFV) on Viral Load, CD4 Count and Adherence.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Effect of Change from TID to BID Nelfinavir (NFV) on Viral Load, CD4 Count and Adherence.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. WeOrB483)

Novak R, Munsiff A, Post JM, Melton D, Diaz-Linares M, Bolanos J, D'Alfonso-Laghi N, Smith R
R. Novak, University of Illinois, 808 S. Wood St., M/C 735, Rm. 886, Chicago, IL 60612, United States, Tel.: +312 996 67 63, Fax: +312 413 16 57, E-mail: rmnovak@uic.edu

BACKGROUND: Trials of NFV 1250mg BID compared to 750mg TID in ARV-naive persons with HIV infection have shown comparable antiretroviral effect and tolerability. This study looks at the effect of switching from TID to BID dosing on adherence and response.

METHODS: We reviewed the records of all HIV-infected patients who switched from TID to BID dosing at 4 medical centers in the U.S. (N = 90). All were on 3 drug therapy including NFV. A standardized case report from was used at all sites to extract data.

RESULTS: Patients included 66 men and 24 women, mean age 41.6 years. Risk factors were 27 MSM ; 33 IDU and 17 heterosexual and 13 unknown. There were 42 naive patients and 48 who were antiretroviral experienced (31 with prior protease inhibitor experience). Poor adherence to the TID regimen was reported in 45 (50%) of study patients, but only 11 (12%) reported poor adherence to the BID regimen (P>0.05). Mean baseline viral load was 4.36 log₁₀ copies/ml. Mean duration of TID NFV was 37 weeks prior to switching to BID. Mean viral load on TID NFV was 2.98 log₁₀ copies/ml, and 40 (44.4%) were below detectable. After changing to BID NFV for mean follow up of 39.8 weeks, the mean viral load fell to 2.69, with 63 (70.0%) falling to undetectable (P = 0.000008). The mean CD4 count (366/mm³) on TID NFV was less than BID (465/mm³; P>0.000001). Mean duration with nondetectable viral load on NFV was 36 weeks. Decline in viral load to nondetectable correlated with good adherence on the TID dosage (R = 0.41, P>0.000008) and with improvement in adherence after change from TID to BID (R = 0.41, P = 0.00008).

CONCLUSIONS: Switching persons on TID to BID NFV resulted in significant further reductions in viral load and increases in CD4 counts. Not surprisingly, improved adherence to the BID regimen appears to account for this trend despite less frequent dosing.

Keywords: AEGIS, Nelfinavir, CD4 Lymphocyte Count, Viral Load, Anti-HIV Agents, HIV Infections, HIV Protease Inhibitors, 4-Acetamido-4'-isothiocyanatostilbene-2,2'-disulfonic, Acid, Stilbenes, HIV, United States, 4-trimethylammonium-4'-isothiocyanostilbene-2,2'-disulfonic, acid, 4-benzamido-4'-isothiocyanostilbene-2,2'-disulfonate, Human, Female, Male
000709
WeOrB483