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Title: Absence of resistance mutations in antiretroviral-naive patients treated with ritonavir-boosted saquinavir
Authors: Jintanat Ananworanich
Bernard Hirschel
Sunee Sirivichayakul
Sasiwimol Ubolyam
Thidarat Jupimai
Wisit Prasithsirikul
Ploenchan Chetchotisakd
Sasisopin Kiertiburanakul
Warangkana Munsakul
Phitsanu Raksakulkarn
Somboon Tansuphasawadikul
Malte Schutz
Wendy Snowden
Kiat Ruxrungtham
The HIV Netherlands Australia Thailand Research Collaboration
Hopitaux universitaires de Geneve
Chulalongkorn University
Bamrasnaradura Infectious Disease Institute
Khon Kaen University
Mahidol University
Vajira Hospital
Sanpatong Hospital
Buddhachinnaraj Hospital
Hoffmann-La Roche Inc.
Roche Products Limited UK
Keywords: Medicine;Pharmacology, Toxicology and Pharmaceutics
Issue Date: 30-Aug-2006
Citation: Antiviral Therapy. Vol.11, No.5 (2006), 631-635
Abstract: Background: There are few data on the selection of resistance by ritonavir-boosted saquinavir (SQV/r), particularly in antiretroviral (ARV)-naive patients. Objective: To assess the incidence of virological failure and evolution of resistance in ARV-naive individuals receiving SQV/r in the induction phase of the Staccato trial. Methods: ARV-naive subjects (n=272) received SQV/r 1,600/100 mg once daily with two nucleoside reverse transcriptase inhibitors (NRTIs) for at least 24 weeks. Patients were defined as having virological failure (VF) when there were two consecutive HIV-1 RNA measurements >500 copies/ml after week 12. Viral genotypes (reverse transcriptase [RT] and protease [PRO]) were determined at baseline in all patients and as close as possible to the time of initial failure in patients experiencing VF. Results: VF was observed in 9/272 patients receiving SQV/r 1,600/100 mg once daily with two NRTIs (3.3%) and occurred 19-48 weeks after treatment initiation. Eight of these patients were evaluable at failure. No major PRO mutations were detected, but 2/8 displayed single new minor PRO substitutions (M36I, L1OI) at VF that were known or suspected not to have been present at baseline; both these substitutions exist as natural polymorphisms. A third patient displayed a single new RT mutation (M1841). Conclusions: SQV/r plus two NRTIs (1,600/100 mg once daily) is an effective initial treatment option for ARV-naive patients, resulting in a low rate of viral rebound (3.3%). Furthermore, no major protease mutations were detected following VF, suggesting that future treatment options are preserved. © 2006 International Medical Press.
ISSN: 13596535
Appears in Collections:Scopus 2006-2010

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