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The success of tenofovir (TNF) and didanosine (ddI) when dosed together using low-dose didanosine 250 mg
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This study was reported in an oral presentation at the 9th Annual Conference of the British HIV Association, by these researchers--M Tung, A Pathmanathan, J Chandra, M Bower, BG Gazzard and MR Nelson Chelsea at the Westminster Hospital, London, UK
Aim: Clinical trials have shown that TNF when co-administered with
ddI at 400 mg increases ddI plasma concentrations >60%, raising
concerns over toxicity. To minimise this interaction, ddI at 250 mg co-administered with TNF and taken simultaneously has been suggested.
Methods: Retrospective study of all patients commenced on
antiretroviral regimens containing TNF with either 400 or 250 mg ddI.
Viral load at the start of the regimen and time to sustained undetec-table
HIV-1 RNA (<400 copies/ml) were noted. All patients who had to
switch regimens due to side effects or experienced virological failure
were documented.
Results: Data are available on 24 patients who commenced regimens
with TNF and 250 mg ddI, and 63 patients on tenofovir and 400 mg ddI.
Four patients were treatment-naive. On-treatment analysis demon-strated
virological suppression to <400 copies/ml by 89% of patients
on ddI 250, and 92% on ddI 400 at 3 months. At 6 months, 100% on
ddI 250 and 91% on ddI 400 remain undetectable. By intention-to-treat
analysis, virological suppression was achieved by 84% on ddI 250
and 92% on ddI 400 at 3 months, 67% on ddI 250 and 84% on ddI 400
at 6 months. In a second cohort of patients with a viral load <400
copies/ml on, or switching to, TNF plus ddI 250 (n=78) or ddI 400
(n=112), time from below the level of detection to treatment failure
between the two groups was not statistically different (P=0.40),
showing that ddI 250 is as efficacious as ddI 400.
Conclusions: Our clinical cohort has shown that TNF with ddI at
250 mg compares favourably with ddI at 400 mg. Thus low-dose ddI at
250 mg plus TNF is an effective combination.
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