Factors Influencing the Emergence of Resistance to Indinavir: Role of Virologic, Immunologic, and Pharmacologic Variables

A major problem with the use of human immunodeficiency virus type 1 (HIV-1) protease inhibitors as monotherapy has been an unacceptably high rate of emergence of resistance. To examine possible influences on the time to emergence of resistance, 24-week data were examined from five studies in which i...

Full description

Saved in:
Bibliographic Details
Published in:The Journal of infectious diseases 1998-08, Vol.178 (2), p.360-367
Main Authors: Drusano, G. L., Bilello, J. A., Stein, D. S., Nessly, M., Meibohm, A., Emini, E. A., Deutsch, P., Condra, J., Chodakewitz, J., Holder, D. J.
Format: Article
Language:English
Subjects:
AIDS
AIDS/HIV
Anti-HIV Agents - therapeutic use
Antibiotics. Antiinfectious agents. Antiparasitic agents
Antiviral agents
Biological and medical sciences
Demography
Drug Resistance, Microbial
Drug Therapy, Combination
Female
Genetic mutation
HIV
HIV 1
HIV Infections - drug therapy
HIV Infections - immunology
HIV Infections - virology
HIV Protease Inhibitors - therapeutic use
HIV-1 - drug effects
HIV-1 - genetics
Human immunodeficiency virus 1
Humans
Indinavir - therapeutic use
Major Articles
Male
Medical sciences
Pharmacology. Drug treatments
Polymerase chain reaction
Protease inhibitors
RNA
Virology
Viruses
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:A major problem with the use of human immunodeficiency virus type 1 (HIV-1) protease inhibitors as monotherapy has been an unacceptably high rate of emergence of resistance. To examine possible influences on the time to emergence of resistance, 24-week data were examined from five studies in which indinavir had been administered as monotherapy or as a component of combination therapy. Monotherapy data indicated a correlation between the level of HIV-1 RNA achieved and the risk of emergence of resistance: the lower the level, the lower the risk. When combination and monotherapy regimens were compared, the group receiving indinavir + lamivudine + zidovudine had a significantly lower risk of resistance, even after adjusting for the minimum HIV-1 RNA level achieved. The findings indicate that if at all possible, HIV-1-infected patients should receive combination chemotherapy to minimize the emergence of resistance to the protease inhibitor portion of the regimen. The goal of therapy should be to decrease the HIV-1 RNA load to a less-than-detectable level.
ISSN:0022-1899
1537-6613
DOI:10.1086/515631