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Long-lasting protection of activity of nucleoside reverse transcriptase inhibitors and protease inhibitors (PIs) by boosted PI containing regimens

Scherrer, A. U. and Boni, J. and Yerly, S. and Klimkait, T. and Aubert, V. and Furrer, H. and Calmy, A. and Cavassini, M. and Elzi, L. and Vernazza, P. L. and Bernasconi, E. and Ledergerber, B. and Gunthard, H. F. and Swiss HIV Cohort Study Shcs, . (2012) Long-lasting protection of activity of nucleoside reverse transcriptase inhibitors and protease inhibitors (PIs) by boosted PI containing regimens. PLoS ONE, Vol. 7, H. 11 , e50307.

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Official URL: http://edoc.unibas.ch/dok/A6338392

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Abstract

Background: The accumulation of mutations after long-lasting exposure to a failing combination antiretroviral therapy (cART) is problematic and severely reduces the options for further successful treatments. Methods: We studied patients from the Swiss HIV Cohort Study who failed cART with nucleoside reverse transcriptase inhibitors (NRTIs) and either a ritonavir-boosted PI (PI/r) or a non-nucleoside reverse transcriptase inhibitor (NNRTI). The loss of genotypic activity 6 months after virological failure was analyzed with Stanford algorithm. Risk factors associated with early emergence of drug resistance mutations (= 1 NRTIs was lower among PI/r-compared to NNRTI-treated individuals 6 months after failure: 8.8% vs. 38.2% (p = 0.009), 7.1% vs. 46.9% (p6 months after failure compared to 41.2%, 49.0% and 63.0% of those who have lost NNRTI activity (all p > 0.001). The risk to accumulate an early NRTI mutation was strongly associated with NNRTI-containing cART (adjusted odds ratio: 13.3 (95% CI: 4.1-42.8), p > 0.001). Conclusions: The loss of activity of PIs and NRTIs was low among patients treated with PI/r, even after long-lasting exposure to a failing cART. Thus, more options remain for second-line therapy. This finding is potentially of high relevance, in particular for settings with poor or lacking virological monitoring.
Faculties and Departments:03 Faculty of Medicine > Departement Biomedizin > Division of Medical Microbiology > Molecular Virology (Klimkait)
UniBasel Contributors:Klimkait, Thomas
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Public Library of Science
e-ISSN:1932-6203
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:31 Aug 2018 06:40
Deposited On:08 May 2015 08:45

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