Objective: to evaluate the long-term safety of a dual regimen of raltegravir (RAL) and ritonavir-boosted protease inhibitor (PI/r) in ARV experienced patients with chronic kidney disease (CKD) Methods: prospective, single centre, study in patients on treatment with 2NRTI + PI/r who switched to RAL and PI/r because of CKD. Demographic, epidemiological, laboratory, viro-immunological data were collected using medical report database. Patients were required to have undetectable viral load at baseline and during the previous 12 months. CKD was defined on the basis of National Kidney Foundation Guidelines (2002). Results: 8 patients were included: 7/1 male, median age 50 years. At baseline all patients had HIV RNA <40 copies/ml and median CD4 540 cells/mmc. 4/8 were receiving TDF/FTC as backbone and 4/8 ABC/3TC; 3/8 showed severe CKD (stage 4), and 5/8 moderate CKD (stage 3). Patients switched from 2NRTI to RAL maintaining the same PI/r (5 LPV/r, 2 DRV/r, 1 ATZ/r). After a median follow-up of 19 months all patients were on treatment. At the latest visit, median CD4 was 661/mmc, HIV RNA was below 40 copies/ml in all patients. 4/8 patients had a mild CKD (Stage 2), 3/8 moderate CKD (stage 3) and 1/8 maintained severe CKD (stage 4). No other clinical or laboratory adverse events were observed. Conclusion: Our data suggest that dual regimen of RAL and PI/r could be an attractive and safe options in patients with chronic kidney disease. Limitation of this study is the low number of patients included. Further randomized clinical trials are needed in order to confirm the efficacy and safety of this strategy.
LONG-TERM SAFETY OF A DUAL REGIMEN OF RALTEGRAVIR AND RITONAVIR-BOOSTED PROTEASE INHIBITOR IN ARV-EXPERIENCED PATIENTS WITH CHRONIC KIDNEY DISEASE
D. Segala;M. Libanore;
2011
Abstract
Objective: to evaluate the long-term safety of a dual regimen of raltegravir (RAL) and ritonavir-boosted protease inhibitor (PI/r) in ARV experienced patients with chronic kidney disease (CKD) Methods: prospective, single centre, study in patients on treatment with 2NRTI + PI/r who switched to RAL and PI/r because of CKD. Demographic, epidemiological, laboratory, viro-immunological data were collected using medical report database. Patients were required to have undetectable viral load at baseline and during the previous 12 months. CKD was defined on the basis of National Kidney Foundation Guidelines (2002). Results: 8 patients were included: 7/1 male, median age 50 years. At baseline all patients had HIV RNA <40 copies/ml and median CD4 540 cells/mmc. 4/8 were receiving TDF/FTC as backbone and 4/8 ABC/3TC; 3/8 showed severe CKD (stage 4), and 5/8 moderate CKD (stage 3). Patients switched from 2NRTI to RAL maintaining the same PI/r (5 LPV/r, 2 DRV/r, 1 ATZ/r). After a median follow-up of 19 months all patients were on treatment. At the latest visit, median CD4 was 661/mmc, HIV RNA was below 40 copies/ml in all patients. 4/8 patients had a mild CKD (Stage 2), 3/8 moderate CKD (stage 3) and 1/8 maintained severe CKD (stage 4). No other clinical or laboratory adverse events were observed. Conclusion: Our data suggest that dual regimen of RAL and PI/r could be an attractive and safe options in patients with chronic kidney disease. Limitation of this study is the low number of patients included. Further randomized clinical trials are needed in order to confirm the efficacy and safety of this strategy.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
