Predictive value of provirus load and DNA human immunodeficiency virus genotype for successful abacavir-based simplified therapy

J Infect Dis. 2003 Jan 1;187(1):38-46. doi: 10.1086/345860. Epub 2002 Dec 13.

Abstract

Of 75 human immunodeficiency virus (HIV) type 1-infected patients successfully responding to 2 nucleoside reverse-transcriptase inhibitors (NRTIs) plus 1 protease inhibitor (PI), 55 started a simplified abacavir (ABC)-based triple NRTI regimen. Influences of DNA load and DNA reverse-transcriptase (RT) mutations on virological responses were assessed at month 6 after initiation of therapy. Baseline heterogeneity was observed: peripheral blood mononuclear cell (PBMC) genotyping showed 31% RT mutations with 1-5 NRTI-related mutations, 78% protease mutations had 1-5 PI-related mutations; and HIV-1-DNA levels were 1.8-3.5 log(10) copies/10(6) PBMC. Outcomes for 49 patients on a regimen of 2 NRTIs plus ABC were as follows: 22 successes, 10 blips ("blip" defined as intermittent plasma HIV-1 RNA levels between 50 and 100 copies/mL and a return to an undetectable level), and 17 failures, whereas, for patients continuing on a regimen of 2 NRTIs plus 1 PI, there were 19 successes and 1 blip. Previous treatment regimens, baseline provirus level, and PBMC genotype predicted virological outcome.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acquired Immunodeficiency Syndrome / drug therapy*
  • Acquired Immunodeficiency Syndrome / virology
  • Adult
  • Antiretroviral Therapy, Highly Active
  • DNA, Viral / analysis*
  • Dideoxynucleosides / administration & dosage*
  • Drug Therapy, Combination
  • Female
  • Genotype
  • HIV Protease Inhibitors / administration & dosage
  • HIV Reverse Transcriptase / genetics*
  • HIV-1 / genetics*
  • Humans
  • Male
  • Middle Aged
  • Mutation
  • RNA, Viral / blood
  • Viral Load

Substances

  • DNA, Viral
  • Dideoxynucleosides
  • HIV Protease Inhibitors
  • RNA, Viral
  • HIV Reverse Transcriptase
  • abacavir