Amprenavir Plus Ritonavir Improves HIV Salvage Therapy Outcome -- HIV/AIDS INFO AND UPDATES

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Date Posted: 21:51:10 02/28/02 Thu
Author: Anonymous
Subject: Amprenavir Plus Ritonavir Improves HIV Salvage Therapy Outcome

Amprenavir Plus Ritonavir Improves HIV Salvage Therapy Outcome

NEW YORK (Reuters Health) Feb 19 - The addition of ritonavir to amprenavir increases plasma concentrations of amprenavir in patients who have failed previous antiretroviral treatment and results in better viral suppression than obtained with amprenavir alone, French researchers report.

Dr. Xavier Duval and colleagues, from the H pital Bichat Claude Bernard, Paris, treated 8 patients with amprenavir and 14 patients with amprenavir plus ritonavir, according to their report in the February issue of Antimicrobial Agents and Chemotherapy.

These patients had previously failed protease inhibitor therapy, and in four of the patients in each group, the researchers detected three or more amprenavir resistant mutations.

Patients in the amprenavir group received amprenavir (1200 mg b.i.d.) plus efavirenz or nevirapine plus one or two nucleoside reverse transcriptase inhibitors. Patients in the other group, who had minimum concentrations of amprenavir below 100 ng/mL seen on two consecutive analyses, were given amprenavir (450 mg b.i.d.) and ritonavir 100 mg b.i.d.

Among patients receiving amprenavir without ritonavir, the minimal plasma concentration of amprenavir was 58 ng/mL compared with 1320 ng/mL among patients receiving amprenavir plus ritonavir. These plasma levels corresponded to median amprenavir inhibitory quotients of 0.2 for patients receiving amprenavir without ritonavir and 7.0 for patients receiving both amprenavir and ritonavir, the French team found.

Given these findings the researchers conclude that "knowledge and/or prediction of inhibitory quotients for all antiviral drugs could aid in the selection of the optimal combination therapy, not only in terms of the antivirals selected but also in terms of the determination of the optimal dose of each component required to achieve maximum antiviral efficacy without compromising tolerance."

Antimicrob Agents Chemother 2002;46:570-574.

Reuters Health Information 2002. � 2002 Reuters Ltd
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