Plasma drug levels, genotypic resistance, and virological response to a nelfinavir plus saquinavir-containing regimen

Abstract
To determine the importance of resistance and drug levels in the response to a dual-protease inhibitor (PI) combination. Prospective study of 62 HIV-positive patients who switched to a salvage regimen including nelfinavir plus saquinavir. Virological response was defined as a decrease in viraemia > 0.5 log10 after 24 weeks. Optimal PI levels were defined as those above the protein binding-corrected 95% inhibitory concentration (IC95), as estimated in the presence of 50% human serum. Baseline median HIV load was 4.78 log10 copies/ml. The median number of mutations in the protease gene was nine (range, 2–25), predominantly at residues 82 (52%), and 90 (40%). After 24 weeks, 45% of patients had responded and 19% were P Genotypic resistance predicts the virological response to a nelfinavir–saquinavir salvage regimen. Our data suggest that higher than optimal drug levels could be necessary to control the replication of many PI-resistant viruses.

This publication has 23 references indexed in Scilit: