Absence of resistance mutations in antiretroviral-naive patients treated with ritonavir-boosted saquinavir

Ananworanich, Jintanat; Hirschel, Bernard; Sirivichayakul, Sunee; Ubolyam, Sasiwimol; Jupimai, Thidarat; Prasithsirikul, Wisit; Chetchotisakd, Ploenchan; Kiertiburanakul, Sasisopin; Munsakul, Warangkana; Raksakulkarn, Phitsanu; Tansuphasawadikul, Somboon; Schutz, Malte; Snowden, Wendy; Ruxrungtham, Kiat

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Title		Absence of resistance mutations in antiretroviral-naive patients treated with ritonavir-boosted saquinavir
Authors		Ananworanich, Jintanat Hirschel, Bernard Sirivichayakul, Sunee Ubolyam, Sasiwimol Jupimai, Thidarat Prasithsirikul, Wisit Chetchotisakd, Ploenchan Kiertiburanakul, Sasisopin Munsakul, Warangkana Raksakulkarn, Phitsanu Tansuphasawadikul, Somboon Schutz, Malte Snowden, Wendy Ruxrungtham, Kiat show all authors [1 - 14]
Published in		Antiviral Therapy. 2006, vol. 11, no. 5, p. 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, L10I) 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 (M184I). 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.
Keywords		Adult — Antiretroviral Therapy, Highly Active — Drug Resistance, Viral/ genetics — Female — Genotype — HIV Infections/ drug therapy/enzymology/virology — HIV Protease/ genetics/metabolism — HIV Protease Inhibitors/ therapeutic use — HIV Reverse Transcriptase/antagonists & inhibitors/ genetics/metabolism — HIV-1/enzymology/ genetics — Humans — Male — Mutation — Reverse Transcriptase Inhibitors/therapeutic use — Ritonavir/ therapeutic use — Saquinavir/ therapeutic use — Thailand — Treatment Failure — Viral Load
Identifiers		PMID: 16964832
Full text		Article - Limited access to UNIGE Other version: http://www.intmedpress.com/journals/avt/abstract.cfm?id=534&pid=88
Structures		Faculté de médecine / Section de médecine clinique / Département de médecine interne des spécialités
Citation (ISO format)		ANANWORANICH, Jintanat et al. Absence of resistance mutations in antiretroviral-naive patients treated with ritonavir-boosted saquinavir. In: Antiviral Therapy, 2006, vol. 11, n° 5, p. 631-635. https://archive-ouverte.unige.ch/unige:7081