Survival of HIV-1 infected multidrug-resistant patients recycling enfuvirtide after a previous failure

Francesca Cossarini, Laura Galli, Caterina Sagnelli, Nicola Gianotti, Hamid Hasson, Massimo Clementi, Alessandro Soria, Stefania Salpietro, Adriano Lazzarin, Antonella Castagna

Research output: Contribution to journalArticle

Abstract

INTRODUCTION: A substantial proportion of HIV-1 infected multidrug-resistant patients previously exposed to enfuvirtide (ENF) have recently recycled the drug as part of their optimized backbone therapy when starting a new antiretroviral regimen including investigational drugs, but no data are available concerning the impact of this strategy on clinical outcome. We evaluated long-term survival in multidrug-resistant patients recycling ENF after a previous failure. METHODS: A retrospective analysis of clinical outcomes in 32 multidrug-resistant patients receiving fewer than 3 active drugs who reintroduced ENF with those who did not. RESULTS: Patients characteristics were not different in the 2 groups at the start of ENF treatment. During follow-up, 6 of the 15 patients (40%) who did not recycle ENF died, as did 3 of the 17 (17.7%) who recycled ENF. Survival probability was higher among patients who recycled ENF (P = 0.0006), also when the analysis was subdivided by CD4 cells gain (P = 0.003) or viral load decrease (P = 0.0003) at the end of the first cycle or the use of investigational drugs during follow-up (P = 0.003). CONCLUSIONS: We found significantly longer survival in patients who reintroduced an ENF-containing regimen after a previous failure on the drug. We therefore suggest considering ENF recycling in patients starting a new regimen with fewer than 3 active drugs.

Original languageEnglish
Pages (from-to)179-184
Number of pages6
JournalJournal of Acquired Immune Deficiency Syndromes
Volume51
Issue number2
DOIs
Publication statusPublished - Jun 2009

Keywords

  • AIDS
  • Enfuvirtide
  • HIV
  • Recycling
  • Resistance
  • Survival

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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