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A pilot study by Harold P. Katner,
MD, of Mercer University School of Medicine in Macon, Ga., and colleagues
assessed the durability of HIV-1 virologic suppression in persons who changed
from a lopinavir/ritonavir-based triple highly active antiretroviral therapy
(HAART) regimen once or twice a day to lopinavir/ritonavir monotherapy once
daily. This was an observational cohort study to determine the proportion of
subjects who sustained virologic suppression through the 48th week following their
switch to the daily lopinavir/ritonavir monotherapy. Researchers presented the
study at IDWeek 2012, a joint meeting of the Infectious Diseases Society of
America (IDSA), the Society for Health and Epidemiology of America (SHEA), the
HIV Medicine Association (HIVMA), and the Pediatric Infectious Diseases Society
(PIDS).
A total of 13 individuals began
lopinavir/ritonavir-based HAART therapy and maintained HIV-1 viral loads ?75
copies/mL) for 48 weeks before enrollment in the study; three failed screening—two
due to elevated viral loads and one because of an inability to tolerate
lopinavir/ritonavir daily. The research continued with 10 individuals, two
female and six male African Americans and one male and one female Caucasian.
Subjects were 27–53 years old, and the mean duration of their therapy before
de-escalation was 252 weeks (105–413 weeks). Mean CD4 count at baseline was 338
cells/m3 (range 120–512 cells/m3). Subjects received frequent clinical,
virologic, and immunologic monitoring.
One subject completed 48 weeks of
daily lopinavir/ritonavir monotherapy and one withdrew at 22 weeks after
experiencing two detectable viral loads five weeks apart. Four subjects had
virologic failure, one of whom developed multiple nucleoside and protease
inhibitor mutations. The study was terminated. None of the subjects reported
severe adverse events.
The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.
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