HIV-1 mutations selected for by β-2′,3′-didehydro-2′,3′-dideoxy-5-fluorocytidine
The present invention discloses a method for treating HIV that includes administering β-D-D4FC or its pharmaceutically acceptable salt or prodrug to a human in need of therapy in combination or alternation with a drug that induces a mutation in HIV-1 at a location other than the 70(K to N), 90 or the 172 codons of the reverse transcriptase region. Also disclosed is a method for using β-D-D4FC as “salvage therapy” to patients which exhibit drug resistance to other anti-HIV agents. β-D-D4FC can be used generally as salvage therapy for any patient which exhibits resistance to a drug that induces a mutation at other than the 70(K to N), 90 or the 172 codons.
1. A method for treating an HIV infection in a human in need thereof comprising administering an effective amount of β-D-D4FC or its pharmaceutically acceptable ester or salt to the human, optionally in a pharmaceutically acceptable carrier, in combination or alternation with an effective amount of a second drug selected from the group consisting of abacavir, indinavir, nelfinavir, saquinavir, amprenavir, efavirenz, delavirdine and nevirapine for the treatment of an HIV infection in a human.
2. The method of claim 1 wherein the second drug in combination or alternation with β-D-D4FC is indinavir.
3. The method of claim 1 wherein the second drug in combination or alternation with β-D-D4FC is nelfinavir.
4. The method of claim 1 wherein the second drug in combination or alternation with β-D-D4FC is saquinavir.
5. The method of claim 1 wherein the second drug in combination or alternation with β-D-D4FC is amprenavir.
6. The method of claim 1 wherein the second drug in combination or alternation with β-D-D4FC is efavirenz.
7. The method of claim 1 wherein the second drug in combination or alternation with β-D-D4FC is delavirdine.
8. The method of claim 1 wherein the second drug in combination or alternation with β-D-D4FC is nevirapine.
9. The method of claim 1 , wherein β-D-D4FC and the second drug are in a pharmaceutically acceptable carrier.
10. The method according to claim 9 , wherein the pharmaceutically acceptable carrier is suitable for oral delivery, intravenous delivery, parenteral delivery, intradermal delivery, subcutaneous delivery or topical delivery.
11. The method of claim 1 , wherein β-D-D4FC and the second drug are in the form of a dosage unit.
12. The method of claim 11 , wherein the dosage unit contains 10 to 1500 mg of each compound.
13. The method of claim 11 , wherein the dosage unit is a tablet or a capsule.
14. The method of claim 1 wherein β-D-D4FC and the second drug are administered in combination.
15. The method of claim 1 wherein β-D-D4FC and the second drug are administered in alternation.
16. A pharmaceutical composition comprising an effective amount of β-D-D4FC or its pharmaceutically acceptable ester or salt, in a pharmaceutically acceptable carrier, in combination with an effective amount of a second drug selected from the group consisting of abacavir, indinavir, nelfinavir, saquinavir, amprenavir, efavirenz, delavirdine and nevirapine.
17. The pharmaceutical composition of claim 16 wherein the second drug in combination with β-D-D4FC is indinavir.
18. The pharmaceutical composition of claim 16 wherein the second drug in combination with β-D-D4FC is nelfinavir.
19. The pharmaceutical composition of claim 16 wherein the second drug in combination with β-D-D4FC is saquinavir.
20. The pharmaceutical composition of claim 16 wherein the second drug in combination with β-D-D4FC is amprenavir.
21. The pharmaceutical composition of claim 16 wherein the second drug in combination with β-D-D4FC is efavirenz.
22. The pharmaceutical composition of claim 16 wherein the second drug in combination with β-D-D4FC is delavirdine.
23. The pharmaceutical composition of claim 16 wherein the second drug in combination with β-D-D4FC is nevirapine.
24. The pharmaceutical composition according to claim 16 , wherein the pharmaceutically acceptable carrier is suitable for oral delivery, intravenous delivery, parenteral delivery, intradermal delivery, subcutaneous delivery or topical delivery.
25. The pharmaceutical composition according to claim 16 , wherein β-D-D4FC and the second drug are in the form of a dosage unit.
26. The pharmaceutical composition according to claim 25 , wherein the dosage unit contains 10 to 1500 mg of each compound.
27. The pharmaceutical composition according to claim 25 , wherein the dosage unit is a tablet or a capsule.