JAC Advance Access published online on February 4, 2004
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkh116
© 2004 by The British Society for Antimicrobial Chemotherapy
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Original article
1 The St Stephen’s Centre, The Chelsea and Westminster
Hospital, London, UK
* Corresponding author. E-mail: j.stebbing{at}imperial.ac.uk.
Received 22 October 2003
; revised 9 December 2004
; accepted 12 December 2003
Background: Treatment failure during
highly active antiretroviral therapy (HAART) is ultimately common and
associated with the development of resistance mutations to both
the specific drug in question and cross-resistance to other available
treatment options. In heavily pre-treated patients, the recycling
of antiretroviral agents that have been utilized previously may,
however, be associated with antiviral efficacy. We therefore conducted
an investigation into the concept of recycling stavudine (d4T, Zerit)
and didanosine (ddI, Videx) with and without hydroxyurea, in the
management of heavily pre-treated HIV-1 infected individuals requiring
salvage therapy (RESTART). Methods: We randomized 21 individuals with treatment
failure to receive stavudine and didanosine or stavudine, didanosine
and hydroxyurea, for 12 weeks prior to optimizing therapy. Viral
load, immunological parameters, genotypic information and the virtual
phenotypes were obtained at baseline and at the end of the study. Results: Significant decreases in viral loads
were observed in both groups during a 12 week study period
(P = 0.04), the addition of hydroxyurea
conferring no additional benefit. This was not predicted by information
from genotypes and virtual phenotypes, and these did not reveal
sensitive or specific phenotypic cut-offs for those individuals
who responded to recycling. Conclusions: Salvage therapy with didanosine
and stavudine can decrease viral loads in heavily pre-treated individuals.
Genotypic and virtual phenotype profiles provide little additional
information in this setting.
Keywords: recycling, phenotype, nucleoside analogues,
HAART
A randomized trial to investigate the recycling
of stavudine
and didanosine with and without hydroxyurea in salvage
therapy (RESTART)
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  A. Woolfson, J. Stebbing, B. D. M. Tom, K. J. Stoner, W. R. Gilks, D. P. Kreil, S. P. Mulligan, L. Belov, J. S. Chrisp, W. Errington, et al. Conservation of unique cell-surface CD antigen mosaics in HIV-1-infected individuals Blood, August 1, 2005; 106(3): 1003 - 1007. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Armbruster, G. M. Stiegler, B. A. Vcelar, W. Jager, U. Koller, R. Jilch, C. G. Ammann, M. Pruenster, H. Stoiber, and H. W. D. Katinger Passive immunization with the anti-HIV-1 human monoclonal antibody (hMAb) 4E10 and the hMAb combination 4E10/2F5/2G12 J. Antimicrob. Chemother., November 1, 2004; 54(5): 915 - 920. [Abstract] [Full Text] [PDF]
|
|