Kaletra monotherapy – a real-life experience
Background: Despite limited evidence, dual- and single-protease inhibitor (PI) regimens are used increasingly in experienced subjects. We present our experience of boosted lopinavir monotherapy (mLPV/r) outside a clinical trial setting.
Methods: We identified all mLPV/r prescriptions up until September 2005 from a prospectively collected database. Baseline data including treatment history, resistance, CD4 and viral load (VL) were collected. CD4 and VL changes over a 12 month period were analysed.
Results: 35 patients prescribed mLPV/r were identified; mean CD4 and VL at switch were 248 cells/mm3 and 54,866 copies/ml respectively and subjects had had a median of 5 previous drug regimens. 2 switched for toxicity, 5 were lost to follow-up. 14/28 (50%) achieved VL<50 copies/ml and 73% a >1log10 reduction. Mean CD4 rise was 115 and 73 cells/mm3 in the undetectable and viraemic groups respectively. 5 patients with major PI mutations at baseline were identified and 3 experienced satisfactory responses (CD4 increase; 2 undetectable, 1 <400 copies/ml). 10 had genotyping on mLPV/r; 2 exhibited new minor mutations. In total, 8/28 subjects switched therapy (3 virological failure, 2 for blips, 1 immunological failure and 2 unclear reasons) and 20 remain on mLPV/r –12/20, 60% are undetectable after a mean of 13.5 months (range 3-34).
Conclusions: In our series of drug-experienced individuals mLPV/r was associated with improved immunological parameters regardless of virological response. 50% achieved an undetectable (less than 50 copies/ml) VL and 73% a greater than 1log10 reduction. As most subjects switched to mLPV/r for poor compliance this data supports this strategy in poorly adherent drug-experienced patients.
AIDS 2006 - XVI International AIDS Conference
"L.Waters, et al.
Kaletra monotherapy – a real-life experience.
AIDS 2006 - XVI International AIDS Conference: