TORONTO-In the realm of public hospitals, protease inhibitors may not be magic for HIV.
A UCSF team says the much-vaunted antiretroviral drugs failed in 53% of 136 patients at San Francisco General after six months of treatment, vs. usual failure rates of just 10% to 20% among clinical-trial patients.
Treatment failure in the San Francisco General group was associated with low T-cell counts and high viral load at the start of therapy, previous antiretroviral drug treatment, and compliance problems, says Dr. Steven Deeks. Clinical-trial patients generally begin in better health, with greater motivation, and with a more promising treatment history.
For the San Francisco General patients, switching to another protease inhibitor didn’t help. Sixteen patients given a new one in a four-drug combo after the first failed had only limited and short-lived response, Dr. Deeks told the Interscience Conference on Antimicrobial Agents and Chemotherapy here.
