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AIDS Research and Human Retroviruses
Short Communication: Nonnucleoside Reverse Transcriptase Inhibitor Fold Change or Plasma Concentration as a Predictor of Virological Response over 48 Weeks in Highly Treatment Experienced HIV-Positive Individuals

To cite this article:
Alan Winston, Janaki Amin, Gill Hales, David A. Cooper, Sean Emery. AIDS Research and Human Retroviruses. April 2006, 22(4): 338-341. doi:10.1089/aid.2006.22.338.

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Alan Winston
National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, NSW 2010, Australia.
HIV, Immunology and Infectious Diseases Clinical Services Unit, St. Vincent’s Hospital, Sydney, 2010, Australia.
Janaki Amin
National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, NSW 2010, Australia.
Gill Hales
National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, NSW 2010, Australia.
David A. Cooper
National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, NSW 2010, Australia.
HIV, Immunology and Infectious Diseases Clinical Services Unit, St. Vincent’s Hospital, Sydney, 2010, Australia.
Sean Emery
National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, NSW 2010, Australia.

The nonnucleoside reverse transcriptase inhibitors (NNRTI) have low genetic barriers to resistance. Resistance can sometimes be overcome by increasing drug exposure. We assessed factors associated with 48-week virological response in treatment-experienced individuals receiving NNRTI therapy including resistance testing results and plasma drug exposure. Of 62 individuals assigned a new NNRTI-based regimen following resistance testing therapy consisted of efavirenz in 35 (56%) and nevirapine in 27 (44%) individuals. NNRTI fold change (FC) was determined from resistance test at baseline and plasma drug concentration at week 4. Mean time weighted change from baseline VL was –0.68 log over 48 weeks. Significant associations with change from baseline VL included baseline VL and FC whereas plasma drug concentration was not associated. In this cohort of highly treatment-experienced individuals treated with NNRTI regimens, we did not observe a significant association between NNRTI plasma concentration and virological response.

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