Virological and immunological effects of treatment interruptions in HIV-1 infected patients with treatment failure
AIDSPublished 1 December 2000
Veronica Miller, Caroline Sabin, Kurt Hertogs, Stuart Bloor, Javier Martínez‐Picado, Richard T. D’Aquila
Citations224
SJR quartileQ1
SJR score1.21
SNIP0.90
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
Changes in surrogate markers suggest that treatment provided benefit in spite of virological failure and resistant virus, and patients with a shift to wild type virus responded better in the short term to treatment re-initiation.
Abstract
Changes in surrogate markers suggest that treatment provided benefit in spite of virological failure and resistant virus. Although patients with a shift to wildtype virus responded better in the short term to treatment re-initiation, the long-term effects are not known and the risk of immune deterioration needs to be carefully considered.
Keywords
Immunology and MicrobiologyMedicine
JAMAAntiretroviral Therapy in Adults
1,034 Citations2000Charles C. J. Carpenter, David A. Cooper +16 more
Journal of VirologyReplicative Fitness of Protease Inhibitor-Resistant Mutants of Human Immunodeficiency Virus Type 1
402 Citations1999Javier Martínez‐Picado, Anu V. Savara +2 more
Results indicate that the mutations which are usually initially selected by nelfinavir and saquinavir, D30N and L90M, respectively, impair fitness, however, additional mutations may improve the replicative capacity of these and other drug-resistant mutants.
AIDSIncreased fitness of drug resistant HIV-1 protease as a result of acquisition of compensatory mutations during suboptimal therapy
376 Citations1999Monique Nijhuis, Rob Schuurman +7 more
The evolution and fitness of viral populations appearing in a patient who received protease monotherapy indicates that the viral population in the patient does not have to represent the fittest possible variants, and thus antiretroviral therapy may drive the viral populations first through a lower fitness level and then to a higher fitness level.
The Journal of Infectious DiseasesSustained CD4<sup>+</sup>T Cell Response after Virologic Failure of Protease Inhibitor–Based Regimens in Patients with Human Immunodeficiency Virus Infection
296 Citations2000Steven G. Deeks, Jason D. Barbour +3 more
For any given HIV RNA level measured 12 weeks after virologic failure, subsequent CD4+ T cell decline was slower in patients receiving a protease inhibitor-based regimen than in a historical control group of untreated patients, suggesting that transient or partial declines in plasma HIV RNA levels can have sustained effects on CD4- T cell levels.
AIDSRapid decline in detectability of HIV-1 drug resistance mutations after stopping therapy
285 Citations1999Helen Devereux, Mike Youle +2 more
This study showed a rapid decline in detectability of the majority of primary mutations within 13 weeks of stopping combination therapy, indicating that HIV-1 resistance testing to direct patients' therapy should only be carried out when on existing therapy, or < 2 weeks off therapy, if reliable decisions are to be made relating to future combinations.
Antimicrobial Agents and ChemotherapyA Family of Insertion Mutations between Codons 67 and 70 of Human Immunodeficiency Virus Type 1 Reverse Transcriptase Confer Multinucleoside Analog Resistance
171 Citations1999Brendan Larder, Stuart Bloor +10 more
The surveyed drug susceptibilities and genotypes of nearly 900 human immunodeficiency virus type 1 (HIV-1) samples revealed complex mutational patterns, including the previously recognized codon 151 multidrug resistance cluster.
The Journal of Infectious DiseasesNovel Four‐Drug Salvage Treatment Regimens after Failure of a Human Immunodeficiency Virus Type 1 Protease Inhibitor–Containing Regimen: Antiviral Activity and Correlation of Baseline Phenotypic Drug Susceptibility with Virologic Outcome
169 Citations1999Steven G. Deeks, Nicholas S. Hellmann +7 more
Non-nucleoside reverse transcriptase inhibitors may represent a potent drug in salvage therapy regimens after failure of an indinavir or ritonavir regimen and Phenotypic resistance testing may provide a useful tool for selecting more effective salvage regimens.
AIDSInterruption of reverse transcriptase inhibitors or a switch from reverse transcriptase to protease inhibitors resulted in a fast reappearance of virus strains with a reverse transcriptase inhibitor-sensitive genotype
154 Citations1999Chris Verhofstede, Filip Van Wanzeele +3 more
The results of this study indicate the sustained lower fitness of mutant strains in vivo, and the importance of 'treatment history' in addition to genotypic and phenotypic markers determined at one time-point, when making therapeutic decisions for patients.
AIDSVirological response to protease inhibitor therapy in an HIV clinic cohort
120 Citations1999Schlomo Staszewski, Veronica Miller +7 more
Starting protease inhibitors therapy with two other new antiretroviral drugs simultaneously with protease inhibitor therapy offers a better best chance of achieving sustained viral load < 500 copies/ml than starting fewer new drugs.
AIDSBaseline HIV drug resistance profile predicts response to ritonavir-saquinavir protease inhibitor therapy in a community setting
118 Citations1999P. Richard Harrigan, Kurt Hertogs +9 more
Baseline resistance to ritonavir or saquinvir or both was associated with a poor antiviral response, and the measurement of drug resistance may assist in optimizing antiretroviral therapy in the clinic.
AIDSEfficacy of a five-drug combination including ritonavir, saquinavir and efavirenz in patients who failed on a conventional triple-drug regimen: phenotypic resistance to protease inhibitors predicts outcome of therapy
109 Citations1999Christophe Piketty, Esther Race +8 more
The results indicate that the combination of ritonavir, saquinavir and efavirenz is safe and effective at 24 weeks in over two-thirds of patients who previously failed on highly active antiretroviral therapy, and that the determination of phenotypic resistance may be of greater value than the detection of resistance mutations to predict the outcome of salvage therapy in this setting.
Antiviral TherapyHIV Drug Susceptibility and Treatment Response to Mega-Haart Regimen in Patients from the Frankfurt HIV Cohort
80 Citations2000Veronica Miller, Alessandro Cozzi‐Lepri +8 more
In this retrospective analysis based on a small number of patients, viral drug susceptibility at baseline was strongly associated with virological outcome at 24 weeks, independent of covariates such as baseline viral load and treatment history.
AIDSThe M184 V mutation in HIV-1 reverse transcriptase (RT) conferring lamivudine resistance does not result in broad cross-resistance to nucleoside analogue RT inhibitors
75 Citations1998Veronica Miller, Martin Stürmer +9 more
M184V per se is not expected to compromise subsequent treatment with NRTI such as didanosine-stavudine or combinations containing abacavir, and cross-resistance was not commonly observed in this lamivudine-treated cohort.
The Journal of Infectious DiseasesCD4 Lymphocyte Count as a Predictor of the Duration of Highly Active Antiretroviral Therapy–Induced Suppression of Human ImmunodeficiencyVirus Load
75 Citations1999Veronica Miller, Schlomo Staszewski +8 more
Lower baseline CD4 cell counts were associated with increased risk of viral rebound; however, this risk was significantly reduced in persons with low baseline CD 4 cell counts who experienced substantial increases in CD4 Cell counts during follow-up.
Antimicrobial Agents and ChemotherapyPatterns of Resistance and Cross-Resistance to Human Immunodeficiency Virus Type 1 Reverse Transcriptase Inhibitors in Patients Treated with the Nonnucleoside Reverse Transcriptase Inhibitor Loviride
59 Citations1998Veronica Miller, Marie‐Pierre de Béthune +6 more
HIV-1 resistance to loviride and the extent of cross-resistance to nevirapine, delavirdine, efavirenz, HBY-097, and tivirapine are characterized and data indicate that the available newer NNRTIs which retain activity against some HIV-1 strains selected by other compounds of this class in vitro may have compromised clinical efficacy in some patients pretreated with NN RTI.
Genome ResearchA novel method for site-directed mutagenesis using PCR and uracil DNA glycosylase.
47 Citations1992Ayoub Rashtchian, Charles G. Thornton +1 more
Application of this method to site-specific mutagenesis of the lacZ alpha gene and the human c-raf oncogene was demonstrated, and the accuracy of the mutations was confirmed by nucleotide sequence analysis as well as phenotypic assays.
Journal of VirologyEffects of Human Immunodeficiency Virus Type 1 Resistance to Protease Inhibitors on Reverse Transcriptase Processing, Activity, and Drug Sensitivity
42 Citations1999Laurence Carron de la Carrière, Sylvie Paulous +2 more
It is reported that some protease inhibitor-resistant viruses also display abnormalities in the processing of reverse transcriptase (RT) by the protease.
Journal of Clinical MicrobiologyHuman Immunodeficiency Virus Type 1 Cloning Vectors for Antiretroviral Resistance Testing
37 Citations1999Javier Martínez‐Picado, Lorraine Sutton +3 more
Novel plasmids and simple methods for rapid cloning of HIV-1 PCR products from patient specimens and their application to generate infectious recombinant virus clones for virus phenotyping and genotyping are described.
PubMedHydroxyurea and didanosine is a more potent combination than hydroxyurea and zidovudine.
28 Citations1997Andrea Foli, Franco Lori +4 more
Results suggest that hydroxyurea in combination with didanosine might be an effective and well-tolerated, simple and affordable, treatment for HIV infection.
Antiviral TherapyLoss of Lamivudine Resistance in a Zidovudine and Lamivudine Dual-Resistant HIV-1 Isolate after Discontinuation of <i>In Vitro</i> Lamivudine Drug Pressure
19 Citations1998Stefano Rusconi, Maria Pia De Pasquale +7 more
In vitro phenotypic and genotypic profiles of an extensively passaged human immunodeficiency virus type 1 clinical isolate are examined, with an M184V mutation in a zidovudine-resistant genetic background, and the genotypesic restoration of the wild-type sequence at codon 184 of reverse transcriptase are restored.
Antiviral TherapyPresence of Genotypic Resistance in Nucleoside Analogue-Treated HIV-1-Infected Patients with Undetectable Viral Load
19 Citations1999Amalia Rubio, M Gómez-Cano +9 more
Standard values of plasma viraemia for measuring the effectiveness of the treatment should be reconsidered when patients are on antiviral regimens of just two or three nucleoside analogues, as even in patients with undetectable viral loads by conventional methods, viral replication may continue and mutations develop.
