Response of HIV positive patients to the long-term salvage therapy by lopinavir/ritonavir

• Published in: Journal of clinical virology Vol. 33; no. 4; pp. 319 - 323
• Main Authors: Václavíková, Jana, Machala, Ladislav, Staňková, Marie, Linka, Marek, Brůčková, Marie, Vandasová, Jana, Konvalinka, Jan
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier B.V 01-08-2005; Elsevier Science
• Subjects: Adult; Biological and medical sciences; CD4 Lymphocyte Count; Drug resistance; Female; Fundamental and applied biological sciences. Psychology; HAART; HIV Protease Inhibitors - therapeutic use; HIV Seropositivity - drug therapy; HIV-1; HIV-1 - drug effects; HIV-1 - physiology; Human immunodeficiency virus; Human viral diseases; Humans; Infectious diseases; Lopinavir; Male; Medical sciences; Microbiology; Middle Aged; Miscellaneous; Protease inhibitors; Pyrimidinones - therapeutic use; Ritonavir - therapeutic use; RNA, Viral - blood; Salvage Therapy; Time Factors; Treatment Outcome; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Virology; HIV-1; ABC; ddC; PR; RT; RTI; ddI; NVP; Drug resistance; LPV; EFV; RTV; RT-PCR; IDV; NRTI; NFV; LPV/r; 3TC; d4Tstavudin; Lopinavir; NNRTI; PBMC; Salvage therapy; Protease inhibitors; PI; SQV; AZT; HAART; Immunopathology; Microbiology; HIV-1 virus; Ritonavir; Retroviridae; AIDS; Immune deficiency; Lentivirus; Virology; Infection; Virus; Resistance; Treatment; Viral disease; Antiviral; Human immunodeficiency virus; Protease inhibitor; HIV-1: Drug resistance
• ISSN: 1386-6532; 1873-5967
• DOI: 10.1016/j.jcv.2004.12.010

The cohort of 19 patients on LPV/r salvage regimen was followed for the period of up to 37.5 months. Patient's virologic response was evaluated with regard to the various baseline characteristics.
A 73.7% of patients (14 out of 19) achieved viral suppression during the first three months of treatment, either complete (47.4%) or partial (26.3%). This effect was only transient in five cases (virologic rebound emerged after 9 months of treatment on average) and in nine cases the treatment was successful in the long-term analysis (HIV RNA plasma level still undetectable at 31st month of the therapy on average with maximum of 36 months).
We analyzed the link between the virologic response and possible predictive factors of treatment efficiency, such as lopinavir mutation score, various individual mutations, previous PI exposure, etc. We also describe changes in the PR sequence associated with poor response to the salvage therapy to LPV/r.
The results of LPV/r salvage therapy were encouraging. About 47% of patients from our study achieved stable suppression of viral replication for 31 months on average. LPV/r proved to be potent inhibitor despite unfavourable prognosis.