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| |  New Antiretrovirals Overpower Resistant HIV Virus Allowing Patients to Achieve Undetectable Viral Loads: Presented at IAS By Ed Susman CAPE TOWN, South Africa -- July 23, 2009 -- Combination treatment with antiretrovirals from 3 classes appears to be able to suppress even multidrug resistant HIV to undetectable levels, researchers said here at the 5th International AIDS Society (IAS) Conference on HIV Pathogenesis, Treatment and Prevention. In a trial conducted by the French National Agency for Research on AIDS and Viral hepatitis (TRIO trial), physicians treated patients who had high levels of resistance-causing HIV mutations with etravirine 200 mg BID, raltegravir 400 mg BID, and darunavir/ritonavir 600 mg/100 mg BID. "HIV-infected patients with highly resistant virus and few remaining options may benefit from an antiretroviral regimen containing these drugs and may achieve sustained virologic suppression comparable to treatment-naïve patients over the first 48 weeks," said Yazdan Yazdanpanah, MD, Tourcoing Hospital, University of Lille, Lille, France. In an oral presentation on July 21, Dr. Yazdanpanah reported that after 48 weeks of treatment, 89 of the 103 patients (~86%) maintained virologic suppression to undetectable levels (<50 copies/mL). Previously, the TRIO study investigators had shown virologic suppression to undetectable levels among 90% of patient after 24 weeks of therapy. To be eligible for the study, patients had to have detectable HIV virus in the blood (>1000 copies/mL) and also had to undergo genotype analysis. If that analysis showed at least 3 major protease inhibitor resistance mutations, 3 nucleoside reverse transcriptase inhibitor resistance mutations, and 3 non-nucleoside reverse transcriptase inhibitor mutations, but did not have 3 or more darunavir mutations, they were permitted into the trial. At baseline the mean viral load for the participants was about 40,000 copies/mL. Dr. Yazdanpanah said that 15 patients experienced grade 3 or 4 adverse events during the 48 weeks of the trial, including 4 events that were considered drug related. One patient discontinued treatment due to a grade 4 skin rash that was accompanied by fever. Grade 3 or grade 4 laboratory abnormalities were observed in 20 patients, but none of these individuals had to discontinue treatment. Participants achieved a median decline in viral load of 2.4 log10, and also achieved a mean CD4+ increase of 108 cells/mm3. [Presentation title: Efficacy and Safety of Raltegravir Plus Etravirine and Darunavir/Ritonavir in Treatment-Experienced Patients With Multidrug-Resistant Virus: 48-Week Results From the ANRS 139 TRIO Trial. Abstract TUPDB204]
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