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The Body Covers: The 12th International AIDS Conference

Combining Indinavir with Ritonavir

Coverage provided by Michael Giordano, M.D.

June 30, 1998

The combination of indinavir and ritonavir (also known as Crixivan and Norvir, respectively) has been attracting attention as a potentially potent and 'user-friendly' combination.

Poster Session 22361: Indinavir Can Be Taken with Regular Meals When Administered with Ritonavir

Dr. Hsu's pharmacokinetic study of the combination of indinavir and ritonavir (400 mg of each every 12 hours) enrolled 13 men and 3 women who were HIV-negative; this is frequently done to get a preliminary look at the way drugs work in the body. The study goal was to determine whether lower -- and in the case of indinavir less frequent -- doses could be given without lowering blood levels. Lower blood levels generally mean less antiretroviral effect. 9 men and 1 woman actually completed the 17-day study; three discontinued because of side effects, while three others withdrew consent.

Because ritonavir inhibits metabolism of indinavir, the study found that the lower dose of indinavir remained in the blood stream longer, even when given with a regular meal. Currently, indinavir can only be taken with low-fat foods. It also showed that twice-daily rather than 3-times daily dosing may be effective in combination with ritonavir. Key results showed:

Given these promising but very preliminary results, studies of this combination will now move forward in HIV-positive people to determine efficacy.

Poster Session 22372: Novel Double Protease Combinations: Combining Indinavir with Ritonavir

Dr. Workman's study went a bit further than Dr. Hsu's, and examined the indinavir (IDV) and ritonavir (RTV) combination, 400 mg of each every 12 hours, given in combination with d4T and 3TC, in HIV-positive patients receiving clinical care.

38 patients were enrolled in the following three groups:

Results were:

These studies help confirm the findings of earlier studies presented at this and previous conferences. One major theme of the conference in Geneva has been the search for easier dosing regimens, because of their obvious advantages in terms of adherence.

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