Titre
Discontinuation of enfuvirtide in heavily pretreated HIV-infected individuals.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Hiv Clinical Trials
Auteur(s)
Elzi, L.
Auteure/Auteur
Kaufmann, G.
Auteure/Auteur
Weber, R.
Auteure/Auteur
Fux, C.A.
Auteure/Auteur
Cavassini, M.
Auteure/Auteur
Hirschel, B.
Auteure/Auteur
Vernazza, P.
Auteure/Auteur
Bernasconi, E.
Auteure/Auteur
Battegay, M.
Auteure/Auteur
Contributrices/contributeurs
Battegay, M.
Bernasconi, E.
Böni, J.
Bucher, HC.
Bürgisser, P.
Calmy, A.
Calmy, S.
Cavassini, M.
Dubs, R.
Dubs, M.
Elzi, L.
Fischer, M.
Flepp, M.
Fontana, A.
Francioli, P.
Furrer, H.
Fux, C.
Gorgievski, M.
Günthard, H.
Hirsch, H.
Hirschel, B.
Hösli, I.
Hösli, Ch.
Kaiser, L.
Karrer, U.
Kind, C.
Klimkait, T.
Ledergerber, B.
Martinetti, G.
Martinez, B.
Müller, N.
Nadal, D.
Opravil, M.
Paccaud, F.
Pantaleo, G.
Rauch, A.
Regenass, S.
Rickenbach, M.
Rudin, C.
Schmid, P.
Schultze, D.
Schüpbach, J.
Speck, R.
Taffé, P.
Telenti, A.
Trkola, A.
Vernazza, P.
Weber, R.
Yerly, S.
Groupes de travail
Swiss HIV Cohort Study
Liens vers les personnes
Liens vers les unités
ISSN
1528-4336
Statut éditorial
Publié
Date de publication
2009
Volume
10
Numéro
4
Première page
207
Dernière page/numéro d’article
214
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Résumé
BACKGROUND: Enfuvirtide was shown to be highly effective in treatment- experienced patients. Data on discontinuation of enfuvirtide and switch to new antiretroviral drugs are scarce. We aimed to evaluate the efficacy and the impact of discontinuing and/or switching enfuvirtide on virologic and clinical parameters in clinical practice.
METHODS: All HIV-infected individuals participating in the Swiss HIV Cohort Study who were treated with enfuvirtide for at least 4 weeks in combination with an optimized background antiretroviral regimen were included in this study.
RESULTS: A total of 151 patients were analyzed. The median baseline CD4 cell count was 108 cells/microL (interquartile range [IQR] 50-206) and HIV RNA was 4.7 log10 copies/mL (IQR 4.1-5.2). Virologic suppression, defined as a viral load below 50 copies/mL at 12 months, was achieved by 57.6% of patients. Overall, a median CD4 cell increase of 121 cells/microL (IQR 50-189) from baseline was noted. Up to 50% of patients discontinued enfuvirtide within the first year of treatment, mainly because of the patient's choice. After discontinuation of enfuvirtide, high rates of virologic failure and clinical progression were observed, notably when CD4 cell count at stopping enfuvirtide was below 100 cells/microL and no switch to new potent antiretroviral drugs such as darunavir, maraviroc, or raltegravir was performed.
CONCLUSIONS: Enfuvirtide provides high virologic and immunologic response in treatment-experienced patients in the setting of clinical practice. Enfuvirtide should not be discontinued but should be replaced by new potent antiretrovirals, particularly in case of severe immunosuppression.
METHODS: All HIV-infected individuals participating in the Swiss HIV Cohort Study who were treated with enfuvirtide for at least 4 weeks in combination with an optimized background antiretroviral regimen were included in this study.
RESULTS: A total of 151 patients were analyzed. The median baseline CD4 cell count was 108 cells/microL (interquartile range [IQR] 50-206) and HIV RNA was 4.7 log10 copies/mL (IQR 4.1-5.2). Virologic suppression, defined as a viral load below 50 copies/mL at 12 months, was achieved by 57.6% of patients. Overall, a median CD4 cell increase of 121 cells/microL (IQR 50-189) from baseline was noted. Up to 50% of patients discontinued enfuvirtide within the first year of treatment, mainly because of the patient's choice. After discontinuation of enfuvirtide, high rates of virologic failure and clinical progression were observed, notably when CD4 cell count at stopping enfuvirtide was below 100 cells/microL and no switch to new potent antiretroviral drugs such as darunavir, maraviroc, or raltegravir was performed.
CONCLUSIONS: Enfuvirtide provides high virologic and immunologic response in treatment-experienced patients in the setting of clinical practice. Enfuvirtide should not be discontinued but should be replaced by new potent antiretrovirals, particularly in case of severe immunosuppression.
PID Serval
serval:BIB_47ED05F30481
PMID
Date de création
2009-10-08T13:11:48.589Z
Date de création dans IRIS
2025-05-20T20:47:10Z