Predictors of virological rebound in HIV-1-infected patients initiating a protease inhibitor-containing regimen

Moing, Vincent Le; Chêne, Geneviève; Carrieri, Patrizia; Alioum, Ahmadou; Brun‐Vézinet, Françoise; Piroth, Lionel; Jp, Cassuto; Jp, Moatti; Raffi, François; Leport, Catherine

doi:10.1097/00002030-200201040-00004

Cited by 151 publications

(104 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, other studies did not ®nd an association between such demographics and drug adherence [14,18]. We also failed to ®nd such association in our study.…”

Section: Discussioncontrasting

confidence: 87%

Determinants of adherence to highly active antiretroviral therapy (HAART) in Chinese HIV/AIDS patients

et al. 2003

HIV Medicine

View full text Add to dashboard Cite

ObjectiveDrug adherence is crucial to the success of highly active antiretroviral therapy (HAART) in the treatment of HIV disease. Adherence to HAART and its determinants may, however, differ across HIV/AIDS populations. MethodsWe retrospectively studied drug adherence by self-report in HIV-1 infected Chinese patients who have been on HAART for at least 1 year as at the end of year 2000. HAART is de®ned as three or more antiretrovirals with at least one protease inhibitor or non-nucleoside analogue reverse transcriptase inhibitor. ResultsThe last drug adherence level assessed by self-report in 161 Chinese patients were: grade A (100%) ± 130, 80.7%; grade B (95±99%) ± 25, 15.5%; grade C (90±94%) ± three, 1.9% and grade D (< 90%) ± three, 1.9%. Patients with full adherence were more likely to have undetectable (< 500 copies/mL) plasma virus level (adjusted OR, 4.22; 95% CI, 1.75±12.33). Patients' demographics, HIV disease status and antiretroviral regimen did not affect adherence. Partial drug adherence was, however, independently associated with the psychosocial factors of missing clinic appointments (adjusted OR, 3.13; 95% CI, 1.23±8.33), forgetfulness (adjusted OR, 4.55; 95% CI, 1.64±12.5) and a busy work life (adjusted OR, 6.67; 95% CI, 1.75±25). ConclusionThere were similarities and differences in determinants affecting HAART adherence in Chinese compared with other patients. Psychosocial factors rather than HIV disease or treatment were more important factors in our Chinese patients. The relevance of patient populations and care setting for adherence to HAART shall be further studied. IntroductionMorbidity and mortality among patients with HIV infection has declined with the advent of highly active antiretroviral therapy (HAART) [1,2]. To have maximal suppression of plasma virus load beyond detection limit is the laboratory target for gauging success of HAART. However, factors such as prior exposure to antiretrovirals [3], advanced HIV disease [4] and suboptimal drug adherence [5] were shown to affect the likelihood of prolonged virus suppression. Furthermore, since antiretroviral therapy is a long-term treatment, and not without side effects, maintaining a high level of drug adherence often represents a big challenge for both the patient and healthcare provider [6]. To maximally substantiate the bene®ts of HAART, measures to continually monitor and enhance patients' drug adherence has become indispensable for effective HIV management nowadays [7].Unfortunately, availability of HAART for treating HIV/AIDS patients has so far been largely limited to the developed Western countries. Hence, most studies on drug adherence to HAART had originated from these countries. A variety of factors has been found to predict antiretroviral MethodsThis was a retrospective study conducted at one of the largest HIV clinical services in Hong Kong ± the Integrated Treatment Centre of the Department of Health. In early 1997, shortly after the availability of HAART in our clinic, we commenced a drug adherence counselling program...

show abstract

“…However, other studies did not ®nd an association between such demographics and drug adherence [14,18]. We also failed to ®nd such association in our study.…”

Section: Discussioncontrasting

confidence: 87%

Determinants of adherence to highly active antiretroviral therapy (HAART) in Chinese HIV/AIDS patients

et al. 2003

HIV Medicine

View full text Add to dashboard Cite

show abstract

“…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.…”

supporting

confidence: 53%

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

Masquelier

Droz

Dary

et al. 2003

Antimicrob Agents Chemother

View full text Add to dashboard Cite

show abstract

“…Combination therapy is generally accepted as a necessity to prevent or delay selection of inhibitor-resistant viral mutants (10,19,46,52,56,70,71,93). However, when a mutagenic agent is one of the components of drug therapy, the sequential administration of giving the inhibitor first and then the mutagenic agent can be more effective than the corresponding combination treatment (77).…”

Section: Discussionmentioning

confidence: 99%

Ribavirin Can Be Mutagenic for Arenaviruses

Moreno

Gallego

Sevilla

et al. 2011

J Virol

View full text Add to dashboard Cite

Arenaviruses include several important human pathogens, and there are very limited options of preventive or therapeutic interventions to combat these viruses. An off-label use of the purine nucleoside analogue ribavirin (1-␤-D-ribofuranosyl-1-H-1,2,4-triazole-3-carboxamide) is the only antiviral treatment currently available for arenavirus infections. However, the ribavirin antiviral mechanism action against arenaviruses remains unknown. Here we document that ribavirin is mutagenic for the prototypic arenavirus lymphocytic choriomeningitis virus (LCMV) in cell culture. The mutagenic activity of ribavirin on LCMV was observed under single-and multiple-passage regimes and could not be accounted for by a decrease of the intracellular GTP pool promoted by ribavirin-mediated inhibition of inosine monophosphate dehydrogenase (IMPDH). Our findings suggest that the antiviral activity of ribavirin on arenaviruses might be exerted, at least partially, by lethal mutagenesis. Implications for antiarenavirus therapy are discussed.

show abstract

Predictors of virological rebound in HIV-1-infected patients initiating a protease inhibitor-containing regimen

Abstract: Initiation of treatment at a stage of preserved immunity is associated with a more durable virological response under protease inhibitor. Every effort should be made to monitor and strengthen adherence to therapy, even in patients having early virological response.

Cited by 151 publications

References 26 publications

Determinants of adherence to highly active antiretroviral therapy (HAART) in Chinese HIV/AIDS patients

Determinants of adherence to highly active antiretroviral therapy (HAART) in Chinese HIV/AIDS patients

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

Ribavirin Can Be Mutagenic for Arenaviruses

Contact Info

Product

Resources

About