HIV Infections Clinical Trial
Official title:
A 48-Weeks National Multicenter Randomized Open Clinical Trial Evaluating Tolerance and Efficacy of a Treatment Simplification by Lopinavir/Ritonavir Versus Continuation of Current Treatment in HIV-Infected Patients With a Viral Load Inferior to 50 Copies/mL Since 6 Months At Least
The purpose of this study is to compare the efficacy and tolerance of a treatment simplification by a Lopinavir/ritonavir monotherapy versus continuation of current treatment in HIV-infected patients
Highly active antiretroviral therapy (HAART) has made a significant impact on the natural
history of HIV-1 infection, but toxicities and complexities of therapy limit long-term
efficacy, and make simpler yet effective HAART regimens highly desirable. Previous attempts
to 'de-intensify' protease inhibitor (PI)-based therapy by discontinuing reverse
transcriptase inhibitors (RTI) after achieving viral suppression met with failure, probably
because plasma levels of most individually administered PI are too low to inhibit viral
replication consistently.
Low-dose ritonavir substantially enhances lopinavir plasma levels, and lopinavir/ritonavir
(LPV/r) is effective as part of a combination therapy in both naive and PI-experienced
patients. Furthermore, lopinavir is known to have a high genetic barrier to selection of
resistance. LPV/r monotherapy could thus have the right combination of potency, favorable
pharmacokinetics, and high genetic barrier needed to suppress viral replication and prevent
the selection of lopinavir resistance. Preliminary results with "maintenance"LPV/r
monotherapy show interesting results but data from randomized studies are needed.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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