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The Body Covers: The XIII International AIDS Conference
Sustained Virologic Suppression in Subjects Switched from Protease Inhibitors to Nevirapine

July 12, 2000

A note from TheBody.com: Since this article was written, the HIV pandemic has changed, as has our understanding of HIV/AIDS and its treatment. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!

  • Sustained virologic suppression in subjects switched from protease inhibitors (PIS) to nevirapine (NVP) (Poster, WePeB4198)
    Authored by G. Cotton (United Kingdom)


One of the concerns about switching from protease inhibitors to NNRTIs has been that, by doing so, we would sacrifice some of the potency of the antiretroviral regimens and that patients would develop virologic failure. There is a growing body of evidence that tells us that is not the case. In this poster, Cotton (who works for Boehringer Ingelheim) reviewed eleven studies published or presented at international meetings in 1998 and 1999 that reported PI replacement with NVP (NRTIs were also changed in some cases).

A total of 370 HIV-suppressed patients who switched therapy were identified. In an on-treatment analysis at three and six months 281/303 (93%) and 176/204 (86%) patients respectively had maintained undetectable viral loads. The entry criteria was not the same in all studies, and some included patients with multi-nucleoside experience, so results are not directly comparable to other studies presented in this and other meetings in a more controlled population. In general, nevirapine is very well tolerated except for patients who develop a rash -- which in this composite analysis, had a frequency of only 4%. During this meeting we also learned that prednisone does not prevent rashes associated with nevirapine (see poster WePpB1378). Metabolic parameters improve quickly after the switch, and although a head-to-head comparison has not been performed with efavirenz, nevirapine seems to be more "lipid-friendly." The practical implication of this and other switch presentations is that our fears about lack of potency of some NNRTI-based regimens are not justified.

A note from TheBody.com: Since this article was written, the HIV pandemic has changed, as has our understanding of HIV/AIDS and its treatment. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!

See Also
More on HIV Medications
More Research on Protease Inhibitors



  
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Please note: Knowledge about HIV changes rapidly. Note the date of this summary's publication, and before treating patients or employing any therapies described in these materials, verify all information independently. If you are a patient, please consult a doctor or other medical professional before acting on any of the information presented in this summary. For a complete listing of our most recent conference coverage, click here.

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