Effectiveness of tipranavir versus darunavir as a salvage therapy in HIV-1 treatment-experienced patients

  • Juan Carlos Domínguez-Hermosillo Hospital de Infectologia, National Medical Center “La Raza”, IMSS. Mexico City, Mexico
  • José Antonio Mata-Marin Hospital de Infectologia, National Medical Center “La Raza”, IMSS. Mexico City, Mexico
  • Norma Estela Herrera-González Instituto Politécnico Nacional. Mexico City, Mexico
  • Marcelino Chávez-García Third Level Hospital #25, IMSS. Monterrey, Nuevo León, Mexico
  • Gloria Huerta-García National Medical Center “Siglo XXI”, IMSS, Mexico City, Mexico
  • Nohemí Nuñez-Rodríguez General Hospital #24, IMSS, Mexico City, Mexico
  • José Gerardo García-Gámez Universidad Nacional Autónoma de México, Mexico City, Mexico
  • Anai Jiménez-Romero Universidad Nacional Autónoma de México, Mexico City, Mexico
  • Jesús Enrique Gaytán-Martínez Hospital de Infectologia, National Medical Center “La Raza”, IMSS. Mexico City, Mexico
Keywords: HIV protease inhibitors, highly experienced patients, prospective study

Abstract

Introduction: Although both tipranavir (TPV) and darunavir (DRV) represent important options for the management of patients with multi-protease inhibitor (PI)-resistant human immunodeficiency virus (HIV), currently there are no studies comparing the effectiveness and safety of these two drugs in the Mexican population. The aim of this study was to compare the effectiveness of TPV versus DRV as a salvage therapy in HIV-1 treatment-experienced patients.

Methodology: This was a comparative, prospective, cohort study. Patients with HIV and triple-class drug resistance evaluated at the Hospital de Infectología “La Raza”, National Medical Center, were included. All patients had the protease and retrotranscriptase genotype; resistance mutation interpretation was done using the Stanford database.

Results: A total of 35 HIV-1 triple-class drug-resistant patients were analyzed. All of them received tenofovir and raltegravir, 22 received darunavir/ritonavir (DRV/r), and 13 received tipranavir/ritonavir (TPV/r) therapies. The median baseline RNA HIV-1 viral load and CD4+ cell count were 4.34 log (interquartile range [IQR], 4.15–4.72) and 267 cells/mm3 (IQR, 177–320) for the DRV/r group, and 4.14 log (IQR, 3.51–4.85) and 445 cells/mm3 (IQR, 252–558) for the TPV/r group. At week 24 of treatment, 91% of patients receiving DRV/r and 100% of patients receiving TPV/r had an RNA HIV-1 viral load < 50 copies/mL and a CD4+ cell count of 339 cells/mm3 (IQR, 252–447) and 556 cells/mm3 (IQR, 364–659), respectively.

Conclusions: No significant difference was observed between DRV/r and TPV/r in terms of virological suppression in HIV-1 patients who were highly experienced in antiretroviral therapy.

Author Biographies

Juan Carlos Domínguez-Hermosillo, Hospital de Infectologia, National Medical Center “La Raza”, IMSS. Mexico City, Mexico

Infectologist.

Department of Infectious Diseases.

José Antonio Mata-Marin, Hospital de Infectologia, National Medical Center “La Raza”, IMSS. Mexico City, Mexico

Infectologist.

Department of Infectious Diseases.

Norma Estela Herrera-González, Instituto Politécnico Nacional. Mexico City, Mexico
Unidad de Posgrado e Investigación.
Marcelino Chávez-García, Third Level Hospital #25, IMSS. Monterrey, Nuevo León, Mexico
AIDS Clinic.
Gloria Huerta-García, National Medical Center “Siglo XXI”, IMSS, Mexico City, Mexico
Department of Pediatric Infectology.
Nohemí Nuñez-Rodríguez, General Hospital #24, IMSS, Mexico City, Mexico
AIDS Clinic.
José Gerardo García-Gámez, Universidad Nacional Autónoma de México, Mexico City, Mexico
Faculty of Medicine.
Anai Jiménez-Romero, Universidad Nacional Autónoma de México, Mexico City, Mexico
Faculty of Medicine
Jesús Enrique Gaytán-Martínez, Hospital de Infectologia, National Medical Center “La Raza”, IMSS. Mexico City, Mexico
Department of Infectious Diseases.
Published
2016-09-30
How to Cite
1.
Domínguez-Hermosillo JC, Mata-Marin JA, Herrera-González NE, Chávez-García M, Huerta-García G, Nuñez-Rodríguez N, García-Gámez JG, Jiménez-Romero A, Gaytán-Martínez JE (2016) Effectiveness of tipranavir versus darunavir as a salvage therapy in HIV-1 treatment-experienced patients. J Infect Dev Ctries 10:982-987. doi: 10.3855/jidc.6629
Section
Original Articles