THERAPEUTIC STRATEGIES AND USE OF LOPINAVIR/RITONAVIR IN PATIENTS WITH HIGHLY RESISTANT HUMAN IMMUNODEFICIENCY VIRUS
ZHONG CHEN 1, 3, TONG WANG 2, CAIHONG WU 2, KEJI DENG 2, MIN WANG 3, HUI QI 3, NING WANG 3, YING LI 3, YONG DENG 3, GUIYING CAO 3, SHENGMING LIU 1*
1Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China
2MOE Key Laboratory of Tumour Molecular Biology, Institute of Life and Health Engineering, College of Life Science and Technology, Jinan University First Affiliated Hospital, Guangzhou, Guangdong, China
3Department of Infection and Immunology, The First Hospital of Changsha City, Changsha, 410000, Hunan, China
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This research was designed to demonstrate the pre-treatment prevalence of drug resistance (DR) and resistance mutation sites (MSs) in highly resistant human immunodeficiency virus (HIV) infected patients, along with assessing the differences between HIV-1 DNA and HIV-1 RNA resistance, and evaluating the efficacy of lopinavir and ritonavir application. The study focused on 420 newly diagnosed HIV-1-infected patients. Prior to antiviral therapy, HIV-1 RNA resistance testing was performed to analyse the prevalence of resistance and resistance mutations. In addition, HIV-1 DNA genotypic resistance was simultaneously assessed in treatment-naive patients to evaluate its clinical significance. The effect of lopinavir/ritonavir treatment was observed on CD4+ cell count, HIV-1 RNA load and safety indicators (aspartate aminotransferase (AST), blood glucose (BG), triglyceride (TG), cholesterol (Cho)) before and after treatment. The results showed that the success rate of HIV-1 RNA pol region amplification (73.10%) was lower than that of HIV-1 DNA pol region amplification (92.86%). The median CD4+ cell count before treatment was 213 cells/μL, and after 12, 24, 36, 48 and 96 weeks of treatment, the median CD4+ cell counts were 303 cells/μL, 352 cells/μL, 381 cells/μL, 399 cells/μL and 476 cells/μL, respectively. The virologic suppression rate of HIV RNA < 50 copies/mL with lopinavir/ritonavir was greater than 75% at all time points. In conclusion, lopinavir/ritonavir demonstrated remarkable efficacy in the treatment of highly resistant HIV infection and HIV-1 DNA resistance testing provided comprehensive information for resistance monitoring.