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Interactions Among Combinations of Two and Three Protease Inhibitors Against Drug-Susceptible and Drug-Resistant HIV-1 Isolates

Tremblay Cécile; Merrill, Debra P.; Chou, Ting-Chao; Hirsch, Martin S.
JAIDS Journal of Acquired Immune Deficiency Syndromes: December 15th, 1999

Summary:Protease inhibitors used in combination with reverse transcriptase inhibitors have demonstrated potent anti-HIV-1 activity in vitro as well as in vivo. We evaluated interactions among five protease inhibitors: indinavir (IDV), ritonavir (RTV), saquinavir (SQV), amprenavir (APV), and nelfinavir (NFV), when used in combinations of two and three drugs in vitro against several HIV-1 isolates, including those susceptible and resistant to various nucleoside and nonnucleoside reverse transcriptase inhibitors. Interactions ranged from synergy to slight antagonism depending on the viral isolates and the experimental conditions employed. Further clinical evaluation of protease inhibitor combinations is warranted.

Address correspondence and reprint requests to Martin S. Hirsch, Infectious Diseases Unit, Gray 5, Massachusetts General Hospital, Fruit Street, Boston, MA 02114, U.S.A.; email: hirsch.martin@mgh.

This study was presented in part at the XII World Conference on AIDS, Geneva, Switzerland, 1998 [abstract 41201].

Manuscript received July 8, 1999; accepted October 14, 1999.

© 1999 Lippincott Williams & Wilkins, Inc.