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Switch from Enfuvirtide to Raltegravir in Virologically Suppressed Multidrug-Resistant HIV-1-Infected Patients: A Randomized Open-Label Trial
Clinical Infectious Diseases, 09/17/09

Castro ND et al. – A switch to raltegravir was safe, well tolerated, and virologically non–inferior to the maintenance of enfuvirtide in patients infected with multidrug-resistant HIV-1 infection who were receiving suppressive antiretroviral therapy.

Exclusive Author Commentary
Dr Jean-Michel Molina, 09/19/09

In this switch/simplification trial, raltegravir, in combination with a boosted PI and NRTIs, was non-inferior to the continuation of enfuvirtide in patients with multi-resistant viruses. Raltegravir however had no better antiviral activity as shown by the similar proportion of patients with plasma HIV RNA levels < 50 cp/ml, and there was a trend toward more adverse events in the raltegravir arm, not so surprising in a switch study. Finally, the only true virologic failure occured in the raltegravir arm in a patient with a baseline GSS score below 1, a reminder that raltegravir should be combined with active drugs to prevent virologic failure (see results of the switchmrk trial).

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