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Retrospective analysis of the use of Tenofovir DF in a private practice
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Tenofovir DF (TFV) was approved by the FDA on October 26, 2001 as the first nucleotide analogue for the treatment of HIV-1 infection. As of today, there have been no reports on the use of TFV in private practice. We sought to reveal the type of patients (pts) in whom TFV was used as an antiretroviral therapy (ART) and to evaluate early clinical response.
We conducted a retrospective chart review of all HIV-1 infected pts at Anderson IDC Clinic in Florida. All patients who received TFV were included in the analysis, including the pts in the Expanded Access Program. Pts were stratified into treatment groups based on the reason for using TFV as part of ART. When available, data from wks 4-8 and 12-24 was recorded to determine early clinical response.
135 pts taking TFV were identified and stratified as follows: naive (4), side effects (22), simplification (20), intensification (3), 1st regimen failure (9), 2nd regimen failure (16), salvage (56), others (5).
Of the pts who switched to TFV due to side effects from another ART, 17 switched from d4T to TFV due to peripheral neuropathy; symptoms improved in 14 (82%) of these pts in the first month. Other switch reasons included: 2-CNS (EFV), 2-anemia (AZT), 1-rash (ABC); all symptoms improved after switching to TFV, without discontinuation of therapy.
Overall, 24 pts received TFV as part of a QD regimen and 11 were co-infected with active Hepatitis B.
Of the 25 pts failing their 1st or 2nd regimen, 9, with data, had HIV-1 RNA <400 c/mL. In the salvage group, there is data on 33 pts: seventeen (52%) had HIV-1 RNA <400 c/mL at wk 24, eight (24%) had >1.0 log reduction in HIV-1 RNA at wk 8, and eight (24%) had no clinical response. There was no discontinuation of TFV due to side effects
Authors concluded that TFV, in combination with other ART drugs, appears to be a favorable treatment option and can be used as part of different treatment strategies. TFV may be a simple option to treat some adverse events caused by other ART.
[MoPeA3005] E. DeJesus, R. Oritz, R.T. Anderson IDC Research Initiative, 685 Palm Springs Drive, Suite 2C, Altamonte Springs, FL, 32701, United States
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