Nonnucleoside reverse transcriptase inhibitor fold change or plasma concentration as a predictor of virological response over 48 weeks in highly treatment experienced HIV-positive individuals

AIDS Res Hum Retroviruses. 2006 Apr;22(4):338-41. doi: 10.1089/aid.2006.22.338.

Abstract

The nonnucleoside reverse transcriptase inhibitors (NNRTI) have low genetic barriers to resistance. Resistance can sometimes be overcome by increasing drug exposure. We assessed factors associated with 48-week virological response in treatment-experienced individuals receiving NNRTI therapy including resistance testing results and plasma drug exposure. Of 62 individuals assigned a new NNRTI-based regimen following resistance testing therapy consisted of efavirenz in 35 (56%) and nevirapine in 27 (44%) individuals. NNRTI fold change (FC) was determined from resistance test at baseline and plasma drug concentration at week 4. Mean time weighted change from baseline VL was -0.68 log over 48 weeks. Significant associations with change from baseline VL included baseline VL and FC whereas plasma drug concentration was not associated. In this cohort of highly treatment-experienced individuals treated with NNRTI regimens, we did not observe a significant association between NNRTI plasma concentration and virological response.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alkynes
  • Anti-HIV Agents / blood
  • Anti-HIV Agents / therapeutic use*
  • Benzoxazines
  • Cohort Studies
  • Cyclopropanes
  • Follow-Up Studies
  • HIV Seropositivity*
  • HIV-1*
  • Humans
  • Linear Models
  • Nevirapine / blood
  • Nevirapine / therapeutic use*
  • Oxazines / blood
  • Oxazines / therapeutic use*
  • RNA, Viral / blood
  • Reverse Transcriptase Inhibitors / blood
  • Reverse Transcriptase Inhibitors / therapeutic use*
  • Time Factors
  • Treatment Outcome

Substances

  • Alkynes
  • Anti-HIV Agents
  • Benzoxazines
  • Cyclopropanes
  • Oxazines
  • RNA, Viral
  • Reverse Transcriptase Inhibitors
  • Nevirapine
  • efavirenz