Raltegravir, etravirine, and ritonavir-boosted darunavir: A safe and successful rescue regimen for multidrug-resistant HIV-1 infection

Arkaitz Imaz, Sara Villar Del Saz, M. Angels Ribas, Adrian Curran, Estrella Caballero, Vicenç Falcó, Manel Crespo, Inma Ocaña, Marjorie Diaz, Enrique Ruiz De Gopegui, Melcior Riera, Esteban Ribera

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55 Citations (Scopus)

Abstract

BACKGROUND:: Boosted darunavir (DRV/r) plus etravirine (ETR), in DUET trials, and raltegravir, in BENCHMRK trials, showed high rates of virologic response in patients with multidrug-resistant HIV-1 infection, particularly when associated with two more fully active antiretroviral drugs. No data from clinical trials, about this combination, are available. PATIENTS AND METHODS:: Thirty-two consecutive heavily pretreated patients with multidrug-resistant HIV-1 infection who started a new salvage regimen with RAL (400 mg twice daily), ETR (200 mg twice daily), and DRV/r (600/100 mg twice daily) were studied. Clinical evaluation and immunologic, virologic, and biochemical parameters were collected at baseline and at Weeks 4, 12, and 24. RESULTS:: Median baseline characteristics were age 44 years, 13 years on antiretroviral therapy, nine prior highly active antiretroviral therapy regimens, 261 CD4 cells/mL, and HIV-1 RNA 4.2 log10 copies/mL. Sixteen (50%) and 14 (44%) patients were enfuvirtide-and tipranavir-experienced, respectively. Three-class resistance mutations were present in all patients. Three patients (9%) had isolates with three ETR resistance mutations. All patients were DRV-naïve with a median of one DRV resistance mutation. At Weeks 4, 12, and 24, respectively, 63%, 81%, and 94% of patients achieved HIV1-RNA less than 50 copies/mL. Median CD4 cell count increased 30, 73, and 103 cells/mL at Weeks 4, 12, and 24, respectively. No patient had adverse events leading to discontinuation of the regimen. CONCLUSION:: The combination of raltegravir, ETR, and DRV/r was a highly effective and well-tolerated antiretroviral salvage regimen in patients infected with multidrug-resistant HIV-1. Copyright © 2009 by Lippincott Williams & Wilkins.
Original languageEnglish
Pages (from-to)382-386
JournalJournal of Acquired Immune Deficiency Syndromes
Volume52
Issue number3
DOIs
Publication statusPublished - 1 Nov 2009

Keywords

  • Antiretroviral drug resistance
  • Darunavir
  • Etravirine
  • HIV infection
  • Raltegravir
  • Salvage treatment

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