Effectiveness of tenofovir-abacavir containing HAART in pretreated HIV1 infected patients
Abstract number: O325
Peña-Monje A., Vinuesa-García D., Tomas-Jimenez C., Muñoz-Medina L., Alvarez M., Martinez-Perez M.A., Garcia-Garcia F., Parra-Ruiz J., Hernandez-Quero J.
Objectives: Although there has been an increase in available antiretroviral for pretreated patients, their high cost and short time since approved make nucleoside reverse transcriptase inhibitors (NRTI) to be the most widely used backbone. However, since pre treated patients usually harbored mutations in reverse transcriptase, frequently tenofovir (TDF) and abacavir (ABC) are the only NRTI available. Since there are no reports about the combination of ABC and TDF, ans some concern about drug-drug interaction, we made a retrospective review to establish the effectiveness of ABC plus TDF as a NRTI backbone of HAART in pretreated patients.
Methods: A single clinic retrospective study including all HIV-1 infected pretreated patients >18 years of age starting ABC-TDF irrespective of their prior HAART. The effectiveness was evaluated in an ITT analysis.
Results: Forty-six patients, 31 men (67%) with a mean age of 43 years (2865) and median CD4 cell count of 447 (751935). Mean HIV-1 viral load was 29400 copies/mL (1985600). Among the sample 12 patients (26%) had undetectable viral load when starting the combination. Failure, as defined, occurred in 26 patients (57%), with 21 patients (46%) having virological failure. The other 5 patients resumed therapy because side effects to any of the drugs (4 patients) or lost to follow up (1 patient). Among these 5 patients, 3 had undetectable HIV-1 viral load when stopped therapy. Median duration of therapy for non-failure patient was 27 months (1154) and 12 months (333) for patients who resumed therapy. When stratified by viral load at the starting of therapy we found that patients who had undetectable viral load had better chance to keep on therapy than patients who started with detectable viral load 8/12 (66%) vs 12/34 (35%), almost reaching statistical significance (p = 0.061).
Conclusion: TDF-ABC backbone should not be routinely used in HIV pre-treated patients. However, if the patient has undetectable viral load, the combination might be used with a high chance of success at 96 weeks follow-up in an ITT analysis.
|Session name:||Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Vienna, Austria, 10 - 13 April 2010|
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