Human Immunodeficiency Virus-Infected Persons with Mutations Conferring Resistance to Zidovudine Show Reduced Virologic Responses to Hydroxyurea and Stavudine-Lamivudine.
Montaner, Julio S. G. 1; Mo, Theresa 1; Raboud, Janet M. 1; Rae, Sandra 1; Alexander, Christopher S. 1; Zala, Carlos 3; Rouleau, Danielle 2; Richard Harrigan, P. 1
[Miscellaneous] Journal of Infectious Diseases. 181(2):729-732, February 2000.

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: 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) virologie 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 virologie 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.

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