Please use this identifier to cite or link to this item:
Title: Monotherapy with darunavir/ritonavir is effective and safe in clinical practice.
Authors: Pasquau, Juan
López-Cortés, Luis
Mayorga, Maria Isabel
Viciana, Pompeyo
Arenas, María Del Mar
Ríos, Maria José
Hernández-Quero, José
Castaño, Manuel
Merino, María Dolores
Márquez, Manuel
Vergara, Antonio
Terrón, Alberto
Téllez, Francisco
Hidalgo-Tenorio, Carmen
metadata.dc.contributor.authoraffiliation: [Pasquau,J;Arenas,MM; Hidalgo-Tenorio,C] Infectious Diseases, Hospital Virgen de las Nieves, Granada, Spain. [López-Cortés,L; Viciana,P] Infectious Diseases, Hospital Virgen del Rocío, Sevilla, Spain. [Mayorga,MI; Castaño,M] Infectious Diseases, Hospital Carlos Haya, Málaga, Spain. [Ríos,MJ] Infectious Diseases, Hospital Virgen de Macarena, Sevilla, Spain. [Hernández-Quero,J] Infectious Diseases, Hospital Clínico San Cecilio, Granada, Spain. [Merino,MD] Infectious Diseases, Complejo Hospitalario de Huelva, Huelva, Spain. [Márquez,M] Infectious Diseases, Hospital Virgen de la Victoria, Málaga, Spain. [Vergara,A] Infectious Diseases, Hospital de Puerto Real, Cádiz, Spain. [Terrón,A] Infectious Diseases, Hospital de Jerez, Jerez, Spain. [Téllez,F] Infectious Diseases, Hospital de La Línea, La Línea (Cádiz), Spain.
Keywords: Infecciones por VIH;Ritonavir;Sulfonamidas;Seguridad del Paciente;Estudios Retrospectivos
metadata.dc.subject.mesh: Medical Subject Headings::Diseases::Immune System Diseases::Immunologic Deficiency Syndromes::HIV Infections
Medical Subject Headings::Chemicals and Drugs::Organic Chemicals::Sulfur Compounds::Thiazoles::Ritonavir
Medical Subject Headings::Chemicals and Drugs::Organic Chemicals::Amides::Sulfonamides
Medical Subject Headings::Health Care::Environment and Public Health::Public Health::Accidents::Accident Prevention::Safety::Patient Safety
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control Studies::Retrospective Studies
Issue Date: 2-Nov-2014
Publisher: BioMed Central
Citation: Pasquau J, López-Cortés L, Mayorga MI, Viciana P, Arenas M Del M, Ríos MJ, et al. Monotherapy with darunavir/ritonavir is effective and safe in clinical practice. J Int AIDS Soc. 2014; 17(4 Suppl 3):19813
Abstract: INTRODUCTION Monotherapy against HIV has undoubted theoretical advantages and has good scientific fundaments. However, it is still controversial and here we will analyze the efficacy and safety of MT with darunavir with ritonavir (DRV/r) on patients who have received this treatment in our hospitals. MATERIALS AND METHODS Observational retrospective study that includes patients from 10 Andalusian hospitals that have received DRV/r in MT and that have been followed over a minimum of 12 months. We carried out a statistical descriptive analysis based on the profile of patients who had been prescribed MT and the efficacy and safety that were observed, paying special attention to treatment failure and virological evolution. RESULTS DRV/r was prescribed to 604 patients, of which 41.1% had a CD4 nadir <200/mmc. 33.1% had chronic hepatitis caused by HCV, had received an average of five lines of previous treatment and had a history of treatment failure to analogues in 33%, to non-analogues 22 and protease inhibitors (PI) in 19.5%. 76.6% proceeded from a previous treatment with PI. The simplification was the main criteria for the instauration of MT in the 81.5% and the adverse effects in the 18.5%. We managed to maintain MT in 84% of cases, with only 4.8% of virological failure (VF) with viral load (VL) >200 c/mL and 3.6% additional losses due to VF with VL between 50 and 200 copies/mL. Thirty three genotypes were performed after failure without findings of resistance mutations to DRV/r or other IPs. Only 23.7% of patients presented some blips during the period of exposition to MT. Eighty seven percent of all determinations of VL had <50 copies/mL, and only 4.99% had >200 copies/mL. Although up to 14.9% registered at some point an AE, only 2.6% abandoned MT because of AE and 1.2% because of voluntary decision. Although the average of total and LDL cholesterol increases 10 mg/dL after 2 years of follow-up, so did HDL cholesterol in 3mg/dL and the values of triglycerides (-14 mg/dL) and GPT (-6 UI/mL) decreased. The average count of CD4 lymphocytes increased from 642 to 714/mm(3) at 24 weeks. CONCLUSIONS In a very broad series of patients obtained from clinical practice, data from clinical trials was confirmed: MT with DRV as a de-escalation strategy is very safe, it's associated to a negligible rate of adverse effects and maintains a good suppression of HIV replication. VF (with >50 or >200 copies/mL) is always under 10% and in any case without consequences.
Description: Journal Article;
ISSN: 1758-2652 (Online)
Appears in Collections:01- Artículos - AGS Campo de Gibraltar
01- Artículos - Hospital de Jerez
01- Artículos - Hospital de Puerto Real
01- Artículos - Hospital Juan Ramón Jiménez
01- Artículos - Hospital Regional de Málaga
01- Artículos - Hospital San Cecilio
01- Artículos - Hospital Virgen de la Victoria
01- Artículos - Hospital Virgen de las Nieves
01- Artículos - Hospital Virgen del Rocío
01- Artículos - Hospital Virgen Macarena

Files in This Item:
File Description SizeFormat 
Pasquau_Monotherapy.pdfMeeting abstract53,7 kBAdobe PDFView/Open

This item is protected by original copyright

This item is licensed under a Creative Commons License Creative Commons