Med Monitor

Patients who switch to Reyataz from other protease inhibitors were shown in a study of 372 HIVers to be less likely to experience rising viral loads or to have to change their regimens again than those continuing their initial protease inhibitor, according to a study presented at the 10th European AIDS Conference. A study in the journal Antiviral Therapy showed that HIV patients who switched to a simplified regimen containing Viread, Videx, and Sustiva maintained viral suppression after 12 months at a level similar to patients who did not change their regimens. Efforts to simplify antiretroviral treatment should not include a regimen containing Viread and Epzicom, since the combination resulted in a virological failure rate of nearly 50% and produced a high rate of genetic mutations conveying resistance to the drugs, according to a study in the December 1 issue of The Journal of Infectious Diseases. Replacing Zerit with Viread after six years of Zerit treatment results in significantly improved total cholesterol and total triglyceride levels, according to a study presented at the Seventh International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV. The Food and Drug Administration has approved new prescribing information for Lexiva that states the protease inhibitor can be safely taken with the heartburn-relief drug Nexium. Although some antacids interact badly with anti-HIV medications, studies show concurrent use of Lexiva and Nexium does not lower blood-based levels of the protease inhibitor. The use of Invirase in combination with Kaletra does not result in suboptimal Kaletra levels, so the combination can be safely used in salvage regimens, according to a report in the December edition of the journal Therapeutic Drug Monitoring. Sustiva-associated neurological side effects tend to last no longer than four weeks, researchers reported in the November 15 Annals of Internal Medicine. The side effects, including bad dreams, anxiety, and depression, also were generally mild. The rate of Viramune-associated adverse side effects during pregnancy is lower than reported in previous studies, according to a study in the November issue of Obstetrics and Gynecology. Although previous studies showed about 29% of pregnant women reported adverse side effects, only 13% of the current study's patients experienced such problems as rash, changes in liver function, or kidney toxicity. HIV patients receiving the tuberculosis treatment rifampicin also can safely take Viramune, according to a study presented at the 45th Interscience Conference on Antimicrobial Agents and Chemotherapy. Study data presented at the 45th Interscience Conference on Antimicrobial Agents and Chemotherapy shows that Tibotec's experimental protease inhibitor TMC114, when boosted with Norvir, is better than the standard of care in patients with highly resistant virus. About 39% of patients taking TMC114 achieved undetectable blood-based viral levels after 24 weeks of treatment, compared to about 7% taking a standard salvage regimen. TMC114 is in Phase III clinical trials. Tibotec has halted a Phase II study of its experimental nonnucleoside drug TMC125 among protease inhibitor'naive HIVers after it was shown to be significantly less effective than a first-line regimen containing a protease drug. A Phase III study of treatment-experienced patients is continuing. Pfizer has announced it discovered serious liver toxicity in a patient enrolled in a clinical trial of its experimental HIV entry inhibitor maraviroc. Pfizer is studying the patient to determine precisely what caused the toxicity problems. The company's announcement followed reports of serious liver toxicity issues in studies of GlaxoSmithKline's experimental CCR5 inhibitor aplaviroc and Schering-Plough's experimental CCR5 inhibitor vicriviroc. Roche has announced it will assist generic-drug manufacturers in sub-Saharan Africa and other developing nations in making generic versions of its anti-HIV drug Invirase.