Journal Article

Combination Therapy with Amprenavir, Abacavir, and Efavirenz in Human Immunodeficiency Virus (HIV)-Infected Patients Failing a Protease-Inhibitor Regimen: Pharmacokinetic Drug Interactions and Antiviral Activity

Judith Falloon, Stephen Piscitelli, Susan Vogel, Brian Sadler, Hiroaki Mitsuya, Mark F. Kavlick, Kazuhisa Yoshimura, Michael Rogers, Steven LaFon, Douglas J. Manion, H. Clifford Lane and Henry Masur

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 30, issue 2, pages 313-318
Published in print February 2000 | ISSN: 1058-4838
Published online February 2000 | e-ISSN: 1537-6591 | DOI: https://dx.doi.org/10.1086/313667
Combination Therapy with Amprenavir, Abacavir, and Efavirenz in Human Immunodeficiency Virus (HIV)-Infected Patients Failing a Protease-Inhibitor Regimen: Pharmacokinetic Drug Interactions and Antiviral Activity

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Patients with plasma viral RNA >50,000 copies/mL, despite a protease-inhibitor regimen, received abacavir, amprenavir, and efavirenz to assess efavirenz-amprenavir drug interactions and to evaluate safety and antiviral response. Patients first received amprenavir with abacavir and other nucleoside analogs. Amprenavir levels were measured before and after adding efavirenz. Patients then received a second protease inhibitor. There was evidence of genotypic and phenotypic resistance at study entry. No patient had study drugs discontinued because of toxicity. Efavirenz decreased the steady-state area under the curve, maximum plasma concentration, and minimum plasma concentration of amprenavir by 24%, 33%, and 43%, respectively. Three of 10 patients had >1.5 log10 viral response to abacavir and amprenavir. All 8 patients who added efavirenz had >0.5 log10 decline in viral load, and this response lasted >24 weeks for 3 of the patients. A combination regimen that included abacavir, amprenavir, and efavirenz was well tolerated and had sustained activity in some patients. Concomitant efavirenz therapy decreases amprenavir concentrations.

Journal Article.  3431 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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