  
Nelfinavir less likely to induce cross-resistance than other protease inhibitors
Last Updated: 2001-04-20 18:08:37 EDT (Reuters Health)
WESTPORT, CT (Reuters Health) - HIV-infected patients who fail an antiretroviral regimen containing nelfinavir are less likely to manifest viral isolates with cross-resistance to other protease inhibitors (PI) than are patients who fail other PI-containing regimens, California-based investigators report.
In a study reported in the March 30th issue of AIDS, Dr. Carol A. Kemper from Santa Clara Valley Medical Center in San Jose and colleagues tested HIV susceptibility to five PIs using isolates from 88 patients who failed an initial PI-containing regimen. The PIs included nelfinavir (55 patients), indinavir (22 patients), saquinavir (7 patients), ritonavir (3 patients) and amprenavir (1 patient).
Eighteen percent of patients had isolates that were susceptible to all five PIs, while 8% had isolates that were not susceptible to any PI. Even after adjusting for the duration of prior PI use, the subjects who received nelfinavir were less likely to have isolates with reduced susceptibility than subjects who received other PIs. Isolates were also more likely to be susceptible to saquinavir and amprenavir than to the other PIs.
"After failure of an initial protease inhibitor-containing regimen, virus isolates usually demonstrated more than four-fold reductions in drug susceptibility to one or more PIs," the authors note. "Nevertheless, most patients (92%) retained HIV that was only partially cross-resistant, and that [virus] remained sensitive to one or more of the alternate agents."
"These data suggest that initial treatment with nelfinavir may provide patients with more future treatment options," the investigator conclude. "This may be especially important for patients similar to those in the current study who had extensive prior nucleoside reverse transcriptase inhibitor use."
AIDS 2001;15:609-615.
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