Ritonavir-boosted HIV protease inhibitors in first-line antiretroviral therapy regimens



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Abstract

The efficiency and safety of antiretroviral therapy (ART) regimens based on ritonavir-boosted HIV protease inhibitors (PIs) were studied in 102 patients with HIV infection. Following 24-week therapy, 65-90% of patients showed a reduction in HIV RNA levels below the threshold of detection by a test system. In the first 6 months of therapy, the increment in the CD4 lymphocyte count was 60-130 cells/μl. The ART regimens comprising ritonavir-boosted PIs were also highly effective in patients with a high baseline HIV RNA level (more than 100000 copies/ml) or a low CD4 lymphocyte count (less than 200 cells/μl). The use of ritonavir-boosted PIs was safe in the absolute majority of patients. The most common adverse reactions were lopinavir/ritonavir-induced diarrhea and atazanavir/ritonavir-induced icteric coloration of the skin and sclerae. In most cases, these were mild and transient. Despite the fact that 65-80% of the patients included into the study were diagnosed as having chronic hepatitis C and before ART 25-29.4% of the patients were recorded to have elevated ALT levels, the use of ritonavir-boosted PIs was safe in the absolute number of patients. In 76-84%% of the patients, adherence to ART was greater than 95%; a half of the patients with incomplete therapy adherence were observed to have lower HIV RNA levels below the threshold of detection by a test system, which is likely to be caused by the improved pharmacokinetics of ritonavir-boosted PIs, with their use the treatment was effective even during incomplete adherence.

About the authors

A V Kravchenko

Federal Research and Methodological Center for AIDS Prevention and Control, Moscow

Email: kravtchenko@hivrussia.net
Federal Research and Methodological Center for AIDS Prevention and Control, Moscow

V G Kanestri

Federal Research and Methodological Center for AIDS Prevention and Control, Moscow

Federal Research and Methodological Center for AIDS Prevention and Control, Moscow

N Yu Gankina

Krasnoyarsk Territorial Center for Prevention and Control of AIDS and Infectious Diseases

Krasnoyarsk Territorial Center for Prevention and Control of AIDS and Infectious Diseases

O A Kozyrev

Volgograd Regional Center for Prevention and Control of AIDS and Infectious Diseases

Volgograd Regional Center for Prevention and Control of AIDS and Infectious Diseases

L E Ibragimova

Ulyanovsk Regional Center for Prevention and Control of AIDS and Infectious Diseases

Ulyanovsk Regional Center for Prevention and Control of AIDS and Infectious Diseases

I Ye Khromova

Kaliningrad Regional Center for Prevention and Control of AIDS and Infectious Diseases

Kaliningrad Regional Center for Prevention and Control of AIDS and Infectious Diseases

S V Minayeva

Nizhni Novgorod Regional Center for Prevention and Control of AIDS and Infectious Diseases

Nizhni Novgorod Regional Center for Prevention and Control of AIDS and Infectious Diseases

References

  1. Клинические рекомендации. ВИЧ-инфекция и СПИД / Под ред. В. В. Покровского. - М., 2006.
  2. Кравченко А. В., Ситдыкова Ю. Р., Серебровская Л. В. и др. Комбинированная антиретровирусная терапия больных ВИЧ-инфекцией с использованием "усиленных" ингибиторов протеазы ВИЧ // Инфекц. бол. - 2003. - Т. 1, № 1. - С. 14-19.
  3. Кравченко А. В., Беляева В. В., Ситдыкова Ю. Р. и др. Факторы, определяющие эффективность высокоактивной антиретровирусной терапии у больных ВИЧ-инфекцией // Эпидемиол. и инфекц. бол. - 2005. - № 5. - С. 53-58.
  4. Кравченко А. В., Салит И., Беляева В. В. и др. Влияние приверженности лечению на эффективность высокоактивной антиретровирусной терапии у взрослых больных инфекцией ВИЧ // Фарматека. - 2005. - № 19. - С. 81-85.
  5. Кравченко А. В. Современные подходы к началу высокоактивной антиретровирусной терапии и выбор оптимальной схемы лечения первой линии // Фарматека. - 2008. - № 19. - С.79-83.
  6. Кравченко А. В., Юрин О. Г., Беляева В. В., Покровский В. В. Лечение ВИЧ-инфекции, вызываемой вирусом иммунодефицита человека, в Российской Федерации // Тер. арх. - 2009. - Т.81, № 4. - С. 64-69.
  7. European AIDS Clinical Society Issues New Guidelines for Treatment of HIV. October, 2008 (http://www.hivandhepatitis.com).
  8. Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents // Developed by the Panel on Clinical Practices for Treatment of HIV Infection convened by the Department of Health and Human Services (DHHS) November 3, 2008 (http://AIDSinfo.nih.gov).
  9. Hammer S. M., Eron J. J., Reiss P. et al. Antiretroviral treatment of adult HIV infection: 2008 recommendations of the International AIDS Society-USA panel // J. A. M. A. - 2008. - Vol. 300. - P. 555-570.
  10. Mills A., Nelson M., Jayaweera D. et al. ARTEMIS: Efficacy and safety of darunavi/ritonavir (DRV/r) 800/100 mg once-daily vs lopinavir/ritonavir (LPV/r) in treatment-naive, HIV-1-infected patients at 96 Wks // 48th International Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2008). Washington, DC. Oct. 25-28, 2008. - Washington, 2008. Abstr. H-1250c.
  11. Molina J. M., Andrare-Villanueva J., Echevarria J. et al. Atazanavir/ritonavir vs lopinavir/ritonavir in antiretroviral-naive HIV-1-infected patients: CASTLE 96 week efficacy and safety // Program and Abstracts of the 48th Annual ICAAC/IDSA 46th Annual Meeting, Oct. 25-28, 2008, Washington, DC. - Washington, 2008. - Abstr. H-1250d.
  12. Pulido F., Baril J. G., Staszewski S. et al. Long-term efficacy and safety of fosamprenavir + ritonavir (FPV/r) versus lopinavir/ ritonavir (LPV/r) over 96 weeks // 47th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2007). Chicago, Sept. 17-20, 2007. - Chicago, 2007. - Abstr. H-361.

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