CMEonHIV.com is dedicated to providing online CME presentations (slides with voiceover) on HIV/AIDS for healthcare professionals given by local and international experts to keep you up-to-date on the ongoing developments in the field.
Conference
"Fosamprenavir - A new option in Protease Inhibitor Therapy" Dr. Jürgen Rockstroh (biography) English - 2005-02-18 - 52 minutes
Summary : In this presentation, Dr. Rockstroh begins by reviewing the present treatment regimens available and employed in Germany. He discusses the tendency for patients to discontinue initial HAART regimens and the rationale behind it, looking specifically at various toxicities.
A therapeutic drug monitoring program by Back et al. in Liverpool showed that when boosting protease inhibitors (PI) with ritonavir, patients exhibited higher drug levels and improved virological response rates. Dr. Rockstroh discusses the ideal scenario which favours a boosted PI therapy.
Dr. Rockstroh focuses on boosted fosamprenavir looking particularly at pharmacokinetic (pk) - profile, resistance barriers, pregnancy, safety profile, pk-interactions, and the APV30005 study. The APV30005 study, a rollover study of APV30002, was designed to address the long term efficacy, safety and tolerability of fosamprenavir over 120 weeks. Dr. Rockstroh reviews the results of this study in detail.
Finally, Dr. Rockstroh presents a case study of a 40 year old man with HIV and the various treatment regimens initiated since his diagnosis in 1993. He addresses the reasons for switching treatment therapies looking specifically at CD4 counts, viral load, toxicities and genotypic resistance profiles.
Learning objectives : After viewing this presentation, the participant will be able to discuss:
- The present treatment strategies employed in Germany;
- The efficacy and ideal scenario for the use of boosted PI’s;
- The use of boosted fosamprenavir;
- A case report of a 40 year old patient and the various treatments initiated over 12 years.
Bibliographic references : Saye H. Khoo, Patrick G. Hoggard, Ian Williams, E. Rhiannon Meaden, Philippa Newton, Edmund G. Wilkins, Alan Smith, John F. Tjia, Judy Lloyd, Kevin Jones, Nick Beeching, Peter Carey, Barry Peters, and David J. BackIntracellular Accumulation of Human Immunodeficiency Virus Protease Inhibitors Antimicrobial Agents and Chemotherapy, October 2002, p. 3228-3235, Vol. 46, No. 10
Patrick G. Yeni; Scott M. Hammer; Martin S. Hirsch; Michael S. Saag; Mauro Schechter; Charles C. J. Carpenter; Margaret A. Fischl; Jose M. Gatell; Brian G. Gazzard; Donna M. Jacobsen; David A. Katzenstein; Julio S. G. Montaner; Douglas D. Richman; Robert T. Schooley; Melanie A. Thompson; Stefano Vella; Paul A. VolberdingTreatment for Adult HIV Infection: 2004 Recommendations of the International AIDS Society-USA PanelJAMA. 2004;292:251-265.
Bluma Brenner, Mark A. Wainberg, Horacio Salomon, Danielle Rouleau, André Dascal, Bonnie Spira, Rafik-Pierre Sekaly, Brian Conway, Jean-Pierre Routy and Investigators of the Quebec Primary Infection StudyResistance to antiretroviral drugs in patients with primary HIV-1 infection Int J of Antimic Agents, Vol 16, Issue 4, Dec 2000, Pages 429-434
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