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Abstract
BOTH ANTIRETROVIRAL DRUG LEVELS AND DRUG RESISTANCE ARE ASSOCIATED WITH SHORT-TERM VIROLOGIC RESPONSES TO SUBSEQUENT DRUG REGIMENS IN CPCRA 046 (GART STUDY)
MAYERS D
Objective: To determine the short-term virological impact of plasma antiretroviral (AR) drug levels and baseline HIV drug resistance on the response to the next antiretroviral regimen for patients (pts) failing on a PI-containing regimen.
Methods: Baseline drug resistance genotypes were obtained for plasma virus from 153 pts entering the GART study. Untimed plasma drug levels (DL) were obtained for 147 pts using LC-MS/MS (VircoPKTM). The distribution of DL was determined for each drug. DL for wk 4 and 8 were averaged for each pt and were classified as above (DLHi) or below (DLLo) the median for each AR drug. The change in log10 plasma HIV RNA (?VL) was the change from baseline to the average of the 4 and 8-wk values. A drug was active of the genotype was interpreted as sensitive or possibly resistant and inactive if the genotype was resistant. A multiple regression analysis was performed of ?VL on the number of drugs in the new AR regimen that were active and AR drug levels above/below the median adjusted for baseline HIV RNA.
Results: Each active drug in the new AR regimen was associated with ?VL = -0.39 (p=0.0001) while each inactive drug had ?VL = -0.20 (p=0.05). Each drug with DLHi was associated with ?VL = -0.39 (p=0.0001) while each drug with DLLo had ?VL = -0.22 (p=0.02). In multivariate models: the ?VL associated with each active drug in an AR regimen with DLHi was –0.49 (p=0.0001), with each active drug with DLLo was –0.27 (p=0.005), with each inactive drug with DLHi was –0.23 (p=0.05), and with each inactive drug with with DLLo was +0.04 (p=0.74).
Conclusions: In salvage therapy, both the number of active drugs and the drug levels for each drug in the new regimen determine the short-term antiviral response.
The 1st. IAS Conference on HIV Pathogenesis and Treatment
Abstract no.
124
Suggested Citation
"MAYERS D
BOTH ANTIRETROVIRAL DRUG LEVELS AND DRUG RESISTANCE ARE ASSOCIATED WITH SHORT-TERM VIROLOGIC RESPONSES TO SUBSEQUENT DRUG REGIMENS IN CPCRA 046 (GART STUDY).
Oral Presentation:
The 1st. IAS Conference on HIV Pathogenesis and Treatment
:
Abstract no.
124"
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