October 23, 2006 (Reuters Health)—Findings from a small study suggest that the fusion inhibitor enfuvirtide (formerly T-20) is a useful therapeutic option for multi-class experienced HIV-infected patients.

While the results support a role for enfuvirtide as rescue therapy, the authors caution that “mutations conferring resistance to enfuvirtide develop rapidly in the absence of viral control confirming that enfuvirtide should be prescribed in association with an active background regimen.”

As reported in the Journal of Medical Virology for October, Dr. Odile Launay, from Hopital Cochin in Paris, and colleagues assessed the virologic and immunologic outcomes of 18 HIV-infected patients who were treated with an enfuvirtide-containing regimen for at least 3 months.

At 3 months, 11 of the patients had HIV RNA levels below 400 copies/mL, including 8 with levels below 50 copies/mL.

Ten patients were treated with enfuvirtide for longer than 12 months. Six of the patients continued to have HIV RNA levels below 50 copies/mL. The median increase in CD4+ cell count was 159 cells/microliter.

Enfuvirtide was generally well tolerated and no patients discontinued the drug due to adverse effects. However, five patients did discontinue use due to virologic failure.

Mutations conferring enfuvirtide resistance were seen in all seven patients with ongoing viral replication, the authors note. In addition, one patient had a new mutation, denoted A50V, that appeared to confer resistance.

J Med Virol 2006;78:1312-1317.




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