Role of Structured Treatment Interruption before a 5-Drug Salvage Antiretroviral Regimen: The Retrogene Study

Lidia Ruiz, Esteban Ribera, Anna Bonjoch, Joan Romeu, Javier Martinez-Picado, Roger Paredes, Marjorie Díaz, Silvia Marfil, Eugenia Negredo, Julia García-Prado, Cristina Tural, Guillem Sirera, Bonaventura Clotet

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Abstract

We evaluated the efficacy of a 5-drug salvage regimen, preceded by a 12-week, structured treatment interruption (STI), in 46 multidrug-treated, human immunodeficiency virus type 1-infected patients with detectable viremia. Patients were randomly assigned to receive a 5-drug salvage regimen immediately (noninterruption [NI] group; n = 24 patients) or after 12 weeks of STI (interruption [I] group; n = 22 patients). At week 48, 45% of patients in the I group and 46% of patients in the NI group had virus loads <50 HIV-1 RNA copies/mL (P = .619). No differences in CD4 cell counts were seen between groups at week 48 (P = .734). A complete reversion to wild-type genotype was detected in 35% of patients in the I group, but this phenomenon did not affect the virological response. The only overall baseline factor associated with ensuing virus suppression was a lower number of nucleoside reverse-transcriptase inhibitor-resistant mutations (relative risk, 0.66; 95% confidence interval, 0.47-0.93; P = .021). A prior STI seems to confer no additional benefit to subsequent virological or immunological outcomes of a salvage regimen.
Original languageEnglish
Pages (from-to)977-985
JournalJournal of Infectious Diseases
Volume188
Issue number7
DOIs
Publication statusPublished - 1 Oct 2003

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    Ruiz, L., Ribera, E., Bonjoch, A., Romeu, J., Martinez-Picado, J., Paredes, R., Díaz, M., Marfil, S., Negredo, E., García-Prado, J., Tural, C., Sirera, G., & Clotet, B. (2003). Role of Structured Treatment Interruption before a 5-Drug Salvage Antiretroviral Regimen: The Retrogene Study. Journal of Infectious Diseases, 188(7), 977-985. https://doi.org/10.1086/378411