López P, Menchaca JI, Aguíñiga MA, Menchaca JI, Wong S, Zapata E, Cano C, Torres R, Amir RR, Flores L, Peredo G, Macías O, Curiel O, Ávila E, Granados E, Torres I, Vázquez M, Pérez U, Pérez CL, Encinas J, González G, Rascón O, Herrera H, Vargas R, Ceja L, Hernández M, Pérez G, Vargas D, Ramos C, Sosa R, Flores A, Castro JC, Dávila A, Muñoz C, Rodríguez E, Pimentel S, Martínez CJC, Oaxaca J, Anda J, García L, Arreola MA

Language: Spanish
References: 0
Page: 113-119
PDF size: 227.98 Kb.

ABSTRACT

Background: Since 2003, recommendations of antiretroviral treatment privilege the prescription of protease inhibitors reinforced with ritonavir. In Mexico they are being indicated without pharmacological reinforcement. This paper reviews national experience related to the efficacy and safety of nelfinavir without pharmacological reinforcement in patients with HIV-1 infection.
Objective: To communicate the experience in Mexico, from 2003 to 2005, with nelfinavir in patients with HIV without previous treatment, as well as to inform the efficacy and safety of nelfinavir in Mexican patients.
Patients and methods: A case-retrospective review of 351 Mexican patients treated with nelfinavir plus two nucleoside reverse transcriptase inhibitors (NRTI) to determine the efficacy and safety of antiretroviral schemes with nelfinavir. Viral load and CD4 results were observed at the beginning and 24 and 48 weeks after treatment to assess the virological and immunological efficacy, as well as the percentage of patients with undetectable viral load. For each case safety parameters, laboratory disorders with the results of the hematic biometry, blood chemistry, liver transaminases and cholesterol were determined. Analysis was made with percentiles and proportions determination.
Results: Reduced viral load (RNA-HIV-1) ≥ 1 log was reached in more than 90% of the patients by week 24 and this was maintained till 48 weeks. More than 70% of patients reached undetectable viral load by week 24 and maintained till 48 weeks. Mean increased CD4 was of 44% (percentile 50) by week 24 and of 45% by week 48. Thirty percent of cases had diarrhea, nausea, abdominal pain, headache in lesser than 20% and renal disorders were not observed. Laboratory data were: increased cholesterol of 100 mg in 17% of patients and of more than 250 mg in 4%. Disorders of liver function tests were degrees I and II.
Conclusion: Although the trend of current treatment is based on reinforced protease inhibitors, this study shows that percentages of efficacy of schemes of nelfinavir are appropriate in Mexican population with HIV infection without sidestepping the new schemes with better efficacy.