July 12, 2000
Studies such as GART and VIRA3001 have showed us that amprenavir is probably the protease inhibitor with more "residual" activity after the failure of other protease inhibitors. In this study, a retrospective review of 30 multi-drug resistant patients treated with amprenavir 1200mg Bid and ritonavir 200mg Bid was presented. After a median follow up of 27 weeks, 50% of the patients had less than 400 copies of HIV RNA. The regimen is well-tolerated metabolically -- with only 10% cholesterol elevations and 20% triglyceride elevations. I think this particular regimen includes too many pills (10 pills twice a day, plus a chosen background regimen). The difficulty of tolerability might even have biased the study against the combination. The bottom line is that, in the case of multi-drug resistance, amprenavir is often the last feasible option.