Foscarnet salvage therapy efficacy is associated with the presence of thymidine-associated mutations (TAMs) in HIV-infected patients

Foscarnet as salvage therapy in HIV-2-infected patient with antiretroviral treatment failure

“…10 More recently, Charpentier et al have suggested that virological response to foscarnet, used as salvage therapy in 13 multi-class experienced patients, may differ according to the number of TAMs. 11 In this heavily ARV-experienced HIV-2-infected patient exhibiting multidrug-resistant virus, foscarnet markedly reduced plasma HIV-2 load and improved immunological status.…”

“…[9][10][11] Two studies reported on foscarnet administration in HIV-1-infected patients exhibiting low CD4 cell count and virological failures with multiple drug-resistant (MDR) viruses. 9,10 Thus, Mathiesen et al reported a HIV-1 plasma viral load median decrease of −1.80 log 10 copies/ml (range: −1.20 to −3.20) after 2 weeks (W2) of foscarnet therapy in seven patients.…”

“…8 Foscarnet associated with zidovudine has been recently proposed as salvage therapy for patients with late-stage HIV-1 infection and limited therapeutic options. [9][10][11] Here we report on the first case of HIV-2-infected patient with viral replication successfully controlled with a foscarnetcontaining regimen.…”

Emergence of cytomegalovirus resistance to foscarnet in a patient receiving foscarnet salvage therapy for multidrug-resistant HIV infection

“…The efficiency of this molecule used as salvage therapy has been recently underlined by several studies, with a markedly decrease of plasma HIV load and an improvement of immunological status. [9][10][11] We report here the first observation describing the emergence of CMV resistance to FOS in a 54-year-old patient receiving FOS salvage therapy for multidrugresistant HIV-1 infection, and the therapeutic management of this FOS-resistant CMV infection with oral valganciclovir (VGCV).…”

Multidrug resistance: a clinical approach

“…In these patients, the addition of a single drug may reduce the risk of immediate clinical progression by temporarily decreasing HIV RNA levels and/or increasing CD4 cell counts [37], but risks and benefits of this decision should be evaluated with the help of an expert [20]. Preliminary data have also illustrated the potential benefits of foscarnet in combination with a thymidine analog, especially when patients have thymidineassociated mutations (TAMs) [40][41][42]. In a recent study, Charpentier et al [40] demonstrated that 61% of patients with severe immunodeficiency and multidrug-resistant HIV achieved HIV RNA levels below the detection limit of 40 copies/ml at week 24 when they took a salvage regimen containing foscarnet, zidovudine, and OBT with only one fully active drug (enfuvirtide or raltegravir) [43].…”