3rd International AIDS Society Conference on HIV Pathogenesis and Treatment Rio de Janeiro - July 24 - 27, 2005

FOSCARNET USED IN SALVAGE THERAPY OF MULTIDRUG RESISTANT HIV-1 INFECTED PATIENTS

IAS Conf HIV Pathog Treat 2005 Jul 24-27;3rd: Abstract No.WePe12.9C16

Katlama C.¹, Canestri A.¹, Wirden M.², Marguet F.¹, Ghosn J.¹, Ouagari Z.¹, Boubezari I.¹, Ktorza N.¹, Agher R.¹, Bossi P.¹, Caumes E.¹, Calvez V.^2
1Service de Maladies Infectieuses, Hôpital Pitié-Salpetriere, Inserm U720, Université Pierre et Marie Curie, Paris, France, ²Service de Virologie, Hôpital Pitié-Salpetriere, Université Pierre et Marie Curie, Paris, France

INTRODUCTION: We evaluated the efficacy of Foscarnet in patients with late stage disease who have exhausted all therapeutic options.

METHODS: A pilot, open-label, add-on study. Patients with 4 drug classes experience including T 20 and Tipranavir (8/10), with plasma HIV-RNA (VL) >50,000 cp/ml, CD4 <100/mm³, were enrolled between 04/04 and 01/05. Foscarnet was given as 5g IV bid with 1500 cc saline isotonic for 6 weeks in addition to their stable failing ART. Patients with >1 log₁₀ decrease in VL at W6 were given a maintenance therapy (MT) with Foscarnet 5g IV bid, 2 consecutive days/week. Primary end-point was the percentage of patients with >1 log₁₀ reduction in VL at W6.

RESULTS: Ten patients were included with a median [range] baseline (BL) VL of 5.16 log₁₀ cp/ml [4.72 – 6.66], a median CD4 of 8 cells/mm³ [1 – 54], a median of 9 NRTI resistance mutation (rm) including 4 TAMs, 2 NNRTI rm and 12 PI rm. One patient discontinued Foscarnet at week 2 for toxicity. By ITT, the median change in VL from BL (DVL) was -2.05 log₁₀ cp/ml [-0.50 – -2.49] at W2, -1.46 log₁₀ cp/ml [-1.02 – -2.88] at W4, -1.63 log₁₀ cp/ml [-2.88 – 0.11] at W6. Overall, 6/10 had >-1 log₁₀ DVL with a median CD4 count of 50 cells/mm³ [1 – 126] at W6. Maintenance Therapy was started in 6 patients. Two patients discontinued for virological failure: at MT-W4 (DVL: -0.38 log₁₀ cp/ml) and at MT-W12 (DVL: -0.25 log₁₀ cp/ml). Median DVL at MT-W12 was -0.85 log₁₀ cp/ml (n=4) [0.04 – -2.81] with a median CD4 of 91 cells/mm³ [17 – 151]. Three patients have reached MT >W24 with sustained VL <5000 cp/ml. No renal insufficiency was observed in MT.

CONCLUSIONS: Foscarnet in addition to HAART induces a profound reduction in VL in patients severely immunosuppressed, with no therapeutic options. This may allow to wait for more potent regimens.

Download PDF of this abstract.

050724
Clinical | WePe12.9C16 | Christine Katlama
Treatment Failure and Salvage Therapy

Copyright © 2005 - International AIDS Society (IAS). All information and content relating to the abstracts from the 3rd International AIDS Society Conference on HIV Pathogenesis and Treatment, such as text, graphics, logos, button icons, images, audio clips, and software is protected by copyright. Permission is hereby granted for the non-commercial use or reproduction of the information on this web site, provided that the use of such information is accompanied by an acknowledgement that IAS is the source of the information and the name of the author of the article.

AEGiS is made possible through unrestricted funding from Boehringer Ingelheim, Bridgestone/Firestone Charitable Trust, Bristol-Myers Squibb Company, Elton John AIDS Foundation, the National Library of Medicine, and donations from users like you. Always watch for outdated information. This article first appeared in 2005. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2005. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. Permission is hereby granted for the non-commercial use or reproduction of the information herein, provided that the use of such information is accompanied by an acknowledgement that IAS is the source of the information and the name of the author of the article.