Human immunodeficiency virus-infected persons with mutations conferring resistance to zidovudine show reduced virologic responses to hydroxyurea and stavudine-lamivudine

J Infect Dis. 2000 Feb;181(2):729-32. doi: 10.1086/315243.

Abstract

The baseline predictors of poor virologic response (<0.5 log decrease in plasma virus load) were examined in two 1996 pilot trials of combination nucleoside-analogue therapy. One trial examined the addition of hydroxyurea to didanosine therapy; the other examined stavudine-lamivudine in combination. In both, predictors of virologic response included the presence of mutations associated with zidovudine resistance. For hydroxyurea, the odds ratio (OR) of failure to achieve a short-term (4 weeks) virologic response in a bivariate logistic regression model was 30.8 (95% confidence interval [CI], 1.75-543; P=.02) for use of lower dose hydroxyurea (500 mg/day) and 14.7 (95% CI, 1.1-200; P=.04) for the presence of a zidovudine-related mutation. For the stavudine-lamivudine study, the OR of failure to achieve a virologic response at 4 weeks in a multivariate logistic regression model was 23 (95% CI, 2.7-199; P=.004) for the presence of a mutation at codon 215.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-HIV Agents / pharmacology*
  • Anti-HIV Agents / therapeutic use*
  • Drug Resistance, Microbial / genetics
  • Drug Therapy, Combination
  • HIV Infections / drug therapy*
  • HIV Infections / virology
  • HIV-1 / drug effects*
  • HIV-1 / genetics*
  • HIV-1 / physiology
  • Humans
  • Hydroxyurea / therapeutic use*
  • Lamivudine / therapeutic use
  • Logistic Models
  • Mutation
  • Nucleic Acid Synthesis Inhibitors / therapeutic use
  • Reverse Transcriptase Inhibitors / pharmacology
  • Reverse Transcriptase Inhibitors / therapeutic use
  • Stavudine / therapeutic use
  • Viral Load
  • Zidovudine / pharmacology*

Substances

  • Anti-HIV Agents
  • Nucleic Acid Synthesis Inhibitors
  • Reverse Transcriptase Inhibitors
  • Lamivudine
  • Zidovudine
  • Stavudine
  • Hydroxyurea