Switch from enfuvirtide to raltegravir in virologically suppressed HIV-1 infected patients: effects on level of residual viremia and quality of life.

Abstract

BACKGROUND:

Raltegravir is a potential treatment option for virologically suppressed HIV-1 infected patients on enfuvirtide with injection site reactions.

OBJECTIVES:

To characterize safety and efficacy of an enfuvirtide to raltegravir switch including changes in T-cells, quality of life, and residual viremia.

STUDY DESIGN:

In patients with viral load <50 copies/mL and injection site reactions, enfuvirtide was switched to raltegravir without additional changes to the antiretroviral regimen. Virologic failure was defined as a viral load >1000 copies/mL or two consecutive viral load measurements between 50 and 1000 copies/mL (low-level viremia). Over the 24 week study, we compared changes in T-cells, injection site reactions, quality of life, and residual viremia, as measured through the single-copy assay which can detect plasma virus down to a single copy, using paired t-tests.

RESULTS:

Fourteen patients with a median CD4+ T-cell count of 420 cells/microL were enrolled. After the switch, two patients experienced virologic failure due to confirmed low-level viremia. However, both patients subsequently were re-suppressed, one without any changes to his regimen. There was no change in CD4+ T-cell count. Injection site reactions resolved. However, there was little reported change in quality of life. The baseline median level of residual viremia was 6 copies/mL and did not change after the switch to raltegravir.

CONCLUSIONS:

A switch to raltegravir in virologically suppressed patients on enfuvirtide is effective in maintaining immunologic and virologic control at 24 weeks but did not result in a change in residual viremia.

• Authors: Philip M Grant, Sarah Palmer, Eran Bendavid, Annie Talbot, Debbie C Slamowitz, Pat Cain, Stacy S Kobayashi, Maya Balamane, Andrew R Zolopa
• Journal: Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology (J Clin Virol) Vol. 46 Issue 4 Pg. 305-8 (Dec 2009) ISSN: 1873-5967 [Electronic] Netherlands
• PMID: 19819183 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• HIV Envelope Protein gp41
• HIV Fusion Inhibitors
• Peptide Fragments
• Pyrrolidinones
• Enfuvirtide
• Raltegravir Potassium

Topics

• CD4 Lymphocyte Count
• Enfuvirtide
• HIV Envelope Protein gp41 (therapeutic use)
• HIV Fusion Inhibitors (therapeutic use)
• HIV Infections (drug therapy)
• HIV-1 (drug effects)
• Humans
• Male
• Middle Aged
• Peptide Fragments (therapeutic use)
• Prospective Studies
• Pyrrolidinones (therapeutic use)
• Quality of Life
• Raltegravir Potassium
• Treatment Outcome
• Viral Load
• Viremia (drug therapy)