Virological response to protease inhibitor therapy in an HIV clinic cohort

Abstract

Starting protease inhibitor therapy with two other new antiretroviral drugs simultaneously with protease inhibitor therapy offers a better best chance of achieving sustained viral load < 500 copies/ml than starting fewer new drugs.

R57K Polymorphism in the Human Immunodeficiency Virus Type 1 Protease as Predictor of Early Virological Failure in a Cohort of Antiretroviral-Naive Patients Treated Mostly with a Nelfinavir-Containing Regimen

“…Finally, a robustness analysis showed that missing data on adherence could not have substantially influenced the results for codon 57. In this study, we found previously reported covariates (9,11,12,14,18,20) associated with VF: age, high plasma HIV-1 RNA at baseline, and failure to adhere to therapy. More surprisingly, the presence of the polymorphism R57K in the HIV-1 protease at baseline therapy was also strongly associated with VF in the first year of follow-up, conversely to the presence and number of major and minor PI resistance mutations at baseline.…”

Viral Evolution in Response to the Broad-Based Retroviral Protease Inhibitor TL-3

“…HIV-1 variants frequently evolve that escape HAART by developing resistance to the inhibitors used (4,15,19,28,40,42). Of patients first treated with a single drug regimen and then going onto HAART, as many as 40% have a viral rebound within the first 3 years, and this number is likely to be higher outside of controlled studies (20,35). Moreover, transmission of drug-resistant HIV has been observed and is likely to increase with more patients on combination therapy (25,38).…”

Benchmarks for antiretroviral therapy

“…Baseline levels of viremia and numbers of CD4 + T cells are both important prognosticators (17)(18)(19)(20); higher levels of viremia and lower numbers of CD4 + T cells predict a shorter duration of viral suppression. The rate of decay of viremia and the depth of the nadir achieved are also prognostically important with regard to viral suppression (20)(21)(22)(23)(24).…”