Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Dec;46(4):305-8.
doi: 10.1016/j.jcv.2009.09.025. Epub 2009 Oct 12.

Switch from enfuvirtide to raltegravir in virologically suppressed HIV-1 infected patients: effects on level of residual viremia and quality of life

Philip M Grant  1 , Sarah Palmer, Eran Bendavid, Annie Talbot, Debbie C Slamowitz, Pat Cain, Stacy S Kobayashi, Maya Balamane, Andrew R Zolopa
Affiliations

Switch from enfuvirtide to raltegravir in virologically suppressed HIV-1 infected patients: effects on level of residual viremia and quality of life

Philip M Grant et al. J Clin Virol. 2009 Dec.

Abstract

Background: Raltegravir is a potential treatment option for virologically suppressed HIV-1 infected patients on enfuvirtide with injection site reactions.

Objectives: To characterize safety and efficacy of an enfuvirtide to raltegravir switch including changes in T-cells, quality of life, and residual viremia.

Study design: In patients with viral load <50 copies/mL and injection site reactions, enfuvirtide was switched to raltegravir without additional changes to the antiretroviral regimen. Virologic failure was defined as a viral load >1000 copies/mL or two consecutive viral load measurements between 50 and 1000 copies/mL (low-level viremia). Over the 24 week study, we compared changes in T-cells, injection site reactions, quality of life, and residual viremia, as measured through the single-copy assay which can detect plasma virus down to a single copy, using paired t-tests.

Results: Fourteen patients with a median CD4+ T-cell count of 420 cells/microL were enrolled. After the switch, two patients experienced virologic failure due to confirmed low-level viremia. However, both patients subsequently were re-suppressed, one without any changes to his regimen. There was no change in CD4+ T-cell count. Injection site reactions resolved. However, there was little reported change in quality of life. The baseline median level of residual viremia was 6 copies/mL and did not change after the switch to raltegravir.

Conclusions: A switch to raltegravir in virologically suppressed patients on enfuvirtide is effective in maintaining immunologic and virologic control at 24 weeks but did not result in a change in residual viremia.

PubMed Disclaimer

References

    1. Lalezari JP, Henry K, O'Hearn M, Montaner JS, Piliero PJ, Trottier B, et al. Enfuvirtide, an HIV-1 fusion inhibitor, for drug-resistant HIV infection in North and South America. N Engl J Med. 2003;348:2175–86. - PubMed
    1. Lazzarrin A, Clotet B, Cooper D, Reyne J, Arasteh K, Nelson M, et al. Efficacy of Enfuvirtide in patients infected with drug-resistant HIV-1 in Europe and Australia. N Engl J Med. 2003;348:2186–95. - PubMed
    1. Harris M, Joy R, Larsen G, Valyi M, Walker E, Frick LW, et al. Enfuvirtide plasma levels and injection site reactions using a needle-free gas-powered injection system (Biojector) AIDS. 2006;20:719–23. - PubMed
    1. Lennox J, DeJesus E, Lazzarin A, Pollard R, Madruga J, Zhao, et al. STARTMRK, a phase III study of the safety and efficacy of raltegravir-based vs efavirenz-based combination therapy in treatment-naive HIV-infected patients. Program of the 48th Annual International Conference on Antimicrobial Agents and Chemotherapy (ICAAC); Washington, DC. October 25-28, 2008; Abstract H-896a.
    1. Steigbigel RT, Cooper DA, Kumar PN, Eron JE, Schechter M, Markowitz M, et al. Raltegravir with optimized background therapy for resistant HIV-1 infection. N Engl J Med. 2008;359:339–54. - PubMed

Publication types