Search

Maintenance with a triple nucleoside reverse transcriptase Inhibitor (NRTI) regimen after successful induction with a dual NRTI/protease inhibitor (PI) combination may be advantageous, because of low pill burden, favorable lipids, and less drug interactions. This strategy to become free of PI-related problems without losing viral efficacy has not been formally tested. We performed a randomized, open-label, multicenter, 96-week comparative study in antiretroviral therapy (ART)-naive patients with CD4 50 copies per milliliter). Two hundred seven patients had similar baseline (BL) char- acteristics: median CD4 180 cells/[mm.sup.3], median VL 5.19 log10 copies per milliliter. One hundred twenty subjects (58%) met randomization criteria. Baseline VL differed significantly between dropouts and randomized subjects (median 5.41 versus 5.06 log10 copies per milliliter, p = 0.017), as did CD4 cells (median 160 and 200 cells/ram3, p = 0.044). Sixty-one subjects received TZV and 59 subjects continued NRTIs/PI. At week 48, 2 patients in the TZV group and 5 in the PI group did not have a sustained virologic suppression (log rank test; p = 0.379). CD4 counts increased significantly in both arms. In ART-naive patients, TZV maintenance had similar antiviral efficacy compared to continued standard ART at 48 weeks after baseline. Patients on successful standard ART can be safely switched to a NRTI-only regimen, at least for the tested time period. DOI: 10.1089/apc.2009.0236

A study to check the effectiveness of HLA-B*5701 screening to prevent hypersensitivity to abacavir is conducted. Results confirm the hypothesis that HLA-B*5701 screening reduced hypersensitivity to abacavir.

Abstract Skin is the most commonly affected organ in patients with HIV, and the incidence of cutaneous adverse reactions in persons infected with HIV versus those who are not infected [...]

The stress being laid on pharmacogenomic research to establish the molecular phenomenon behind adverse drug reactions to help increase efficacy of treatment is discussed.

The high specificity of human leukocyte antigen-B*5701 in the ethnically mixed French population is confirmed and a rapid and inexpensive polymerase chain reaction strategy is used to evaluate the predictiveness of B*5701 screening. The incidence of hypersensitivity before and after screening and the rate of unwarranted interruptions of abacavir therapy have decreased, thereby recommending the implementation of this cost-effective screen before treatment with abacavir.

A 36-year-old man with HIV infection developed a reaction compatible with an abacavir hypersensitivity reaction after switching from the twice-daily to the once-daily formulation. The switch was determined by a more convenient intake. The patient was treated with abacavir twice-daily plus lamivudine and efavirenz for more than 5 years with no side effects. At the time of this change, his CD4 count was 1069 cell/[mm.sup.3] and HIV-RNA undetectable. Our case suggests that patients should be carefully monitored after switching, and warned about the potential effects.

Background: Abacavir (ABC) may be associated with a small, increased risk of myocardial infarction in HIV‐infected adults, possibly related to cytokine‐mediated inflammation. Methods: To evaluate the induction of inflammatory cytokine transcription by ABC, we used samples from women randomized to receive zidovudine/lamivudine/ABC (Trizivir) or lopinavir/ritonavir and zidovudine/lamividine (Kaletra/Combivir) from the third trimester through six‐months postpartum for the prevention of mother‐to‐child transmission (PMTCT). Women were matched by CD4 count and baseline HIV RNA. All women attained viral suppression ( Results: Four cytokines showed a difference in expression between the treatment arms, all in a proinflammatory direction for the ABC arm: CD40LG 1.82‐fold, (p=.027); IL‐8 3.16‐fold (p=.020); LTA 2.82‐fold, (p=.008); and CCL5 −1.67‐fold, (p=.035). At 12‐months postpartum, 6‐months after antiretroviral discontinuation, cytokine expression was similar by treatment arm. Conclusions: We conclude that ABC may upregulate proinflammatory cytokines at the transcriptional level in this population., Introduction Abacavir (ABC) may be associated with a small, increased risk of myocardial infarction (MI) in HIV‐infected adults, possibly related to cytokine‐mediated inflammation; however, no consistent outcome has been found [...]

7‐11 November 2010, Tenth International Congress on Drug Therapy in HIV Infection, Glasgow, UK, Background Recent studies have shown an increase in the incidence of coronary heart disease in HIV‐infected patients on treatment with abacavir (ABC), and platelet hyper‐reactivity induced by this drug has [...]