Journal Article

Effectiveness of Antiretroviral Therapy after Protease Inhibitor Failure: An Analytic Overview

Elena Losina, Runa Islam, Alison C. Pollock, Paul E. Sax, Kenneth A. Freedberg and Rochelle P. Walensky

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 38, issue 11, pages 1613-1622
Published in print June 2004 | ISSN: 1058-4838
Published online June 2004 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/420930
Effectiveness of Antiretroviral Therapy after Protease Inhibitor Failure: An Analytic Overview

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To examine effectiveness of subsequent antiretroviral therapy (ART), studies published during the period of 1 January 1997 through 31 May 2003 involving patients who had failed a protease inhibitor (PI)-containing regimen and were switched to another regimen were reviewed. Twelve studies describing 1197 patients were analyzed. A total of 38% of patients had human immunodeficiency virus (HIV) RNA levels of <500 copies/mL at 24 weeks. After adjustment for baseline HIV RNA level, the rate of virologic suppression ranged from 16% for patients switching drugs within previously failed classes to 54% for nonnucleoside reverse-transcriptase inhibitor (NNRTI)-naive patients switched to boosted PI- and NNRTI-containing regimens. ART regimens in patients who failed a PI-containing regimen provided virologic suppression only in a few patients. The best response was seen in NNRTI-naive patients receiving NNRTI- and boosted PI-containing regimens. New approaches are needed to achieve better suppression in pretreated HIV-infected patients.

Journal Article.  5836 words.  Illustrated.

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

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