• Randomized Salvage Therapy with Saquinavir-Ritonavir (SQV-RTV) versus Saquinavir-Nelfinavir (SQV-NFV) for Highly Experienced HIV-Infected Patients
  Poster 543
  Authored by L. Piroth, M. Grappin, M. Buisson, F. Gourdon, A. Cabie, F. Brunel-Dalmas, G. Peytavin, H. Portier, P. Chavanet

Boosting the levels of protease inhibitors with ritonavir has become an important approach in controlling those with previous protease inhibitor use and resistance. This study followed 31 people all of whom had previous experience. Here they used somewhat novel dosing of the protease inhibitors -- using only 200 mg BID ritonavir with 600 mg. saquinavir, versus nelfinavir at 1000 mg BID with this same dose of saquinavir. No one started on a non-nucleoside here -- so these results only reflect the potency of the dual protease inhibitor combination. The average CD4 count was between 300-400, and the viral load just under 10,000 when the dual protease inhibitor combinations were started.

The results showed a similar outcome from these two regimens, although in neither combination were the majority successfully controlled. Overall, by six months only between 15-20% had a viral load below 200 copies on either combination, and about a third in each group had a drop in viral load of at least one log. These results are similar to other studies seen in the past, and support the need for more potent combinations after protease inhibitor resistance has occurred. Fortunately, other studies at this meeting provide some insight into potentially better approaches to treatment in this circumstance.