- Poster presentation
- Open Access
Excellent short-term CD4 recovery with a PI- and NRTI-sparing regimen in triple-class failure HIV-infected patients: raltegravir, maraviroc, etravirine
© Nozza et al; licensee BioMed Central Ltd. 2008
- Published: 10 November 2008
- Generalize Linear Regression
With the availability of new drug classes, the full suppression is a realistic goal even for heavily pre-treated patients. We prospectively evaluated the magnitude of CD4 recovery (CR) in this setting.
We decided to simultaneously screen triple class failing patients (pts) followed at San Raffaele Hospital in three Expanded Access Programs: raltegravir (MK0518-023), maraviroc (A4001050), etravirine (TMC125-C214). Salvage therapy was prescribed according to: viral tropism, screening genotype and previous resistance tests. Data were collected at baseline (BL) and at 4, 12, 24, 36 and 48 weeks. Generalized linear regression model was applied. Results are reported as median (Q1–Q3).
Group A: RAL+MVC+ETR
Group B: RAL + MVC or ETR + PI sparing OBT**
Group C: RAL + MVC or ETR +PI/r* based OBT**
Group D: RAL + PI/r* based OBT**
At week 24, 14 (93%), 13 (76%), 14 (74%), 15 (94%) had HIV-RNA <50 copies/mL in group A, B, C, D, respectively (p = 0.238).
At multivariable analysis, a significantly different CR was related to therapy group (p = 0.035) and positively related to BL HIV-RNA (p = 0.049). CR was higher in group A (adjusted mean: 214.8 ± 37.3) than group B (129.2 ± 33.5, p = 0.062) or group C (115.7 ± 30.5, p = 0.023) or group D (91.7 ± 33.3, p = 0.005). No independent effect of age (p = 0.834), gender (p = 0.392), HIV risk factor (p = 0.522), CD4% (p = 0.297) and CD4 nadir (p = 0.195) was observed. Despite the high pill number, RAL +MVC+ETR were very well tolerated; serious adverse events were diagnosed in two pts: spondylodiscitis (one), anal cancer (one).
Salvage therapy with RAL+ MVC+ETR showed an excellent short-term CD4 recovery. Reasons for this success could include: presence of active drugs blocking consecutive targets of viral replication, high doses of MVC required with this regimen, avoidance of ritonavir and NRTI toxicity.
This article is published under license to BioMed Central Ltd.