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Lamivudine-Resistant HIV Best Treated Without Interruption

Continued lamivudine treatment may lead to better outcome than complete treatment interruption

THURSDAY, April 13 (HealthDay News) -- HIV-1 infected individuals harboring virus with a lamivudine-resistance mutation in reverse transcriptase (RT) have a better clinical outcome if lamivudine monotherapy is continued compared with complete treatment interruption, according to a report on a randomized pilot study in the April issue of AIDS.

To test treatment interruption for lamivudine-resistant HIV, Antonella Castagna, M.D., of Vita-Salute San Raffaele University in Milan, Italy, and colleagues randomly assigned infected individuals harboring the M184V RT mutation to either lamivudine monotherapy (lamivudine group) or discontinuation of antiretroviral drugs (TI group).

By week 48, 69 percent of TI group and 41 percent of lamivudine group patients had discontinued the study because of immunological or clinical failure, with only TI group patients experiencing high-grade clinical adverse events. CD4 count decline was also lower in the lamivudine group. Immunological and virological responses after reintroduction of therapy was similar in both groups.

"In conclusion, our results indicate that, in patients harboring a lamivudine-resistant virus, lamivudine monotherapy may lead to better immunological and clinical outcomes than complete therapy interruption, without compromising subsequent treatment options," the authors wrote.

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