Amazing results for new drugs for treatment-experienced

For the first time, a new therapy combination has been as effective in people who have experienced multiple treatment failures with multidrug-resistant HIV as in people receiving therapy for the first time.

French researchers combined three new powerful antiretroviral drugs. The trial demonstrates that it is now possible to achieve, at this stage of HIV infection, a viral load below 50 copies.
ANRS 139 TRIO included 103 patients all of whom had a long treatment history: average follow-up for HIV infection of 17 years, on antiretroviral therapy for a median of 13 years.

On average people had drug resistance to the three main classes of antiretrovirals: a median 6 mutations in the case of nucleoside reverse transcriptase inhibitors (NRTIs) such as AZT or d4T, 4 primary mutations for protease inhibitors (PIs) such as saquinavir or atazanavir, and 1 mutation for non-nucleoside reverse transcriptase inhibitors (NNRTIs) such as efavirenz or nevirapine.

Trial participants received a treatment combining three new drugs of
three different classes:
- Darunavir, a new PI boosted with a low dose of another PI (ritonavir);
- Eravirine, a new NNRTI;
- Raltegravir, an integrase inhibitor, a new type of antiretroviral.

In addition to these three antiretrovirals, the patients were able to receive one or more other NRTIs (83% of them did) or enfuvirtide (13.6% of patients received this fusion inhibitor) or both.

After 24 weeks of treatment  90% of patients had an undetectable viral load (<50 copies). At the same time, the median increase in CD4 cells was 99 cells. The treatment was well tolerated, and only one patient stopped treatment because of an adverse drug reaction (rash).
Longer follow-up is under way (up to 96 weeks is planned) to determine whether the antiviral efficacy of this treatment is maintained over the long term. On the basis of these results, it is now possible to offer powerful antiviral therapy to treatment-experienced patients.

The treatment goal for everyone, regardless of whether they are on therapy for the first time or treatment-experienced is now a viral load below 50 copies.