scholarly journals Virological Outcome After Choice of Antiretroviral Regimen Guided by Proviral HIV-1 DNA Genotyping in a Real-Life Cohort of HIV-Infected Patients

2020 ◽  
Vol 34 (2) ◽  
pp. 51-58 ◽  
Author(s):  
Agnès Meybeck ◽  
Enagnon Kazali Alidjinou ◽  
Thomas Huleux ◽  
Anne Boucher ◽  
Macha Tetart ◽  
...  
Keyword(s):  
Real Life ◽  
Virological Outcome ◽  
Dna Genotyping ◽  
Hiv 1

Effectiveness, Durability, and Safety of Dolutegravir and Lamivudine Versus Dolutegravir, Lamivudine, and Abacavir in a Real-Life Cohort of HIV-Infected Adults

2021 ◽  
pp. 106002802110341
Author(s):  
Inés Mendoza ◽  
Alicia Lázaro ◽  
Miguel Torralba
Keyword(s):  
Viral Load ◽  
Safety Profile ◽  
Real Life ◽  
Hazard Ratio ◽  
Treatment Discontinuation ◽  
Treatment Naïve ◽  
Tn 4 ◽  
Risk Of Treatment ◽  
Hiv 1 ◽  
All Treatment

Background: Dolutegravir (DTG) plus lamivudine (2-DR) is suggested as an initial and switch option in HIV-1 treatment. Objective: To analyze the effectiveness, durability, and safety of 2-DR compared with DTG plus abacavir/lamivudine (3-DR). Methods: This was an observational, ambispective study that included all treatment-naïve (TN) and treatment-experienced (TE) patients who started 2-DR or 3-DR between July 1, 2018, and November 30, 2020. The primary end point was noninferiority, at 24 and 48 weeks, of 2-DR versus 3-DR regarding the percentage of patients with viral load (VL)≥50 and 200 copies/mL in TN (4% margin) and VL<50 and 200 copies/mL in TE (margin 12%). Durability of response, and safety were also measured. Results: 242 patients were included (53 TN and 189 TE). Two TN patients on 2-DR had VL≥50 copies/mL and 1 had VL≥200 copies/mL at week 24. In TE patients on 2-DR, 90.2% achieved VL<200 copies/mL at week 24 (difference: 3.8%; 95% CI = −6.3% to 14%) and 91.8% at week 48 (difference: 0.06%; 95% CI = −9% to 10%), meeting noninferiority criteria. Among the 53 TN patients, only 1 VF was observed in 2-DR. In TN patients, the risk of treatment discontinuation was similar between groups (hazard ratio [HR] = 0.37; P = 0.15); similar rates were also found in TE patients (HR = 0.94; P = 0.85). TE patients on 2-DR showed a better safety profile compared with 3-DR patients ( P<0.001). Conclusion and Relevance: Our results did not show noninferiority in terms of virological effectiveness. Nevertheless, all effectiveness measures support the use of 2-DR in a real-life cohort of TN and TE. Additionally, durability and safety of 2-DR were confirmed to be similar to that of 3-DR.

Low efficacy of nevirapine (HIVNET012) in preventing perinatal HIV-1 transmission in a real-life situation

AIDS ◽  
2004 ◽  
Vol 18 (13) ◽  
pp. 1854-1856 ◽  
Author(s):  
Ann Quaghebeur ◽  
Lillian Mutunga ◽  
Fabian Mwanyumba ◽  
Kishor Mandaliya ◽  
Chris Verhofstede ◽  
...  
Keyword(s):  
Real Life ◽  
Life Situation ◽  
Perinatal Hiv ◽  
Real Life Situation ◽  
Hiv 1

scholarly journals Phenotypic analysis of HIV-1 E157Q integrase polymorphism and impact on virological outcome in patients initiating an integrase inhibitor-based regimen

2018 ◽  
Vol 73 (4) ◽  
pp. 1039-1044 ◽  
Author(s):  
Charlotte Charpentier ◽  
Isabelle Malet ◽  
Elisabeth Andre-Garnier ◽  
Alexandre Storto ◽  
Laurence Bocket ◽  
...  
Keyword(s):  
Integrase Inhibitor ◽  
Phenotypic Analysis ◽  
Virological Outcome ◽  
Hiv 1

Effectiveness, Safety, and Costs of Dolutegravir/Abacavir/Lamivudine Single-Tablet Regimen in a Real-Life Cohort of HIV-1 Adult Infected Patients

2020 ◽  
Vol 54 (7) ◽  
pp. 633-643
Author(s):  
Carmen Guadalupe Rodriguez-Gonzalez ◽  
Esther Chamorro-de-Vega ◽  
Cristina Ortega-Navarro ◽  
Roberto Alonso ◽  
Ana Herranz-Alonso ◽  
...  
Keyword(s):  
Cox Regression ◽  
Real Life ◽  
Pill Burden ◽  
Intention To Treat ◽  
Real Life Data ◽  
Single Tablet Regimen ◽  
Study Population ◽  
The Impact ◽  
Hiv 1 ◽  
Treat Analysis

Background: Real-life data on single-tablet regimen (STR) dolutegravir/abacavir/lamivudine (DTG/ABC/3TC) is scarce, and concerns about DTG neuropsychiatric adverse events (NP-AEs) have recently arisen. Objective: To explore the effectiveness and safety, in particular NP-AEs, of DTG/ABC/3TC in a cohort of HIV-1 adult infected patients. Pill burden, adherence to this STR, and the impact of switching on costs were also evaluated. Methods: This was an observational, retrospective study. The study population included antiretroviral therapy (ART)-naive and treatment-experienced (TE) patients who started DTG/ABC/3TC between February 1, 2016, and October 31, 2016. Effectiveness and safety were analyzed at week 48 (W48) by intention-to-treat analysis. The Cox regression model was used to investigate predictors of DTG/ABC/3TC discontinuation. Results: A total of 253 patients were included (44 ART naïve, 209 TE). At W48, the proportion of patients with virological suppression was 72.7% (95% CI = 58.4-87.0) in ART-naive patients, 85.6% (95% CI = 80.3-90.9) in previously suppressed TE patients, and 86.4% (95% CI = 65.1-97.1) in previously not suppressed TE patients. The rate of protocol-defined virological failure was 4.3%. The incidence of AEs was higher in the subgroup of ART-naive patients (56.1% vs 39.0%), with a rate of interruptions for this reason of 13.6% and 7.6%, respectively. The incidence of NP-AEs was 20.6%, with 3.9% of patients requiring discontinuation. Patients who had switched from a raltegravir-containing regimen discontinued DTG/ABC/3TC because of AEs more frequently (relative risk = 2.83; 95% CI = 1.04-7.72; P = 0.041) in the multivariate analysis. After switching to DTG/ABC/3TC, the median pill burden was reduced from 3 to 1 and the proportion of patients with an adherence <90%, from 20.1% to 12.0%. The annual per-patient ART costs increased by €48 (0.6% increase). Conclusion and Relevance: DTG/ABC/3TC is an effective strategy as first-line and switching ART. Our data suggest a worse tolerance in ART-naive patients, although the rate of discontinuation resulting from NP-AEs was relatively low. In the short-term, the adherence was slightly improved without significant changes in costs.

Rilpivirine in HIV-1-positive women initiating pregnancy: to switch or not to switch?

2020 ◽  
Vol 75 (5) ◽  
pp. 1324-1331
Author(s):  
Pierre Frange ◽  
Roland Tubiana ◽  
Jeanne Sibiude ◽  
Ana Canestri ◽  
Cédric Arvieux ◽  
...  
Keyword(s):  
Pregnancy Outcomes ◽  
Viral Suppression ◽  
Hiv Transmission ◽  
Plasma Concentrations ◽  
Safety Data ◽  
Viral Rebound ◽  
Delivery Outcomes ◽  
Virological Outcome ◽  
Adverse Pregnancy ◽  
Hiv 1

Abstract Background Safety data about rilpivirine use during pregnancy remain scarce, and rilpivirine plasma concentrations are reduced during second/third trimesters, with a potential risk of viral breakthroughs. Thus, French guidelines recommend switching to rilpivirine-free combinations (RFCs) during pregnancy. Objectives To describe the characteristics of women initiating pregnancy while on rilpivirine and to compare the outcomes for virologically suppressed subjects continuing rilpivirine until delivery versus switching to an RFC. Methods In the ANRS-EPF French Perinatal cohort, we included women on rilpivirine at conception in 2010–18. Pregnancy outcomes were compared between patients continuing versus interrupting rilpivirine. In women with documented viral suppression (&lt;50 copies/mL) before 14 weeks of gestation (WG) while on rilpivirine, we compared the probability of viral rebound (≥50 copies/mL) during pregnancy between subjects continuing rilpivirine versus those switching to RFC. Results Among 247 women included, 88.7% had viral suppression at the beginning of pregnancy. Overall, 184 women (74.5%) switched to an RFC (mostly PI/ritonavir-based regimens) at a median gestational age of 8.0 WG. Plasma HIV-1 RNA nearest delivery was &lt;50 copies/mL in 95.6% of women. Among 69 women with documented viral suppression before 14 WG, the risk of viral rebound was higher when switching to RFCs than when continuing rilpivirine (20.0% versus 0.0%, P = 0.046). Delivery outcomes were similar between groups (overall birth defects, 3.8/100 live births; pregnancy losses, 2.0%; preterm deliveries, 10.6%). No HIV transmission occurred. Conclusions In virologically suppressed women initiating pregnancy, continuing rilpivirine was associated with better virological outcome than changing regimen. We did not observe a higher risk of adverse pregnancy outcomes.

scholarly journals Presence of Tablet Remnants of Nevirapine Extended-Release in Stools and Its Impact on Virological Outcome in HIV-1-Infected Patients: A Prospective Cohort Study

PLoS ONE ◽  
2015 ◽  
Vol 10 (10) ◽  
pp. e0140574 ◽  
Author(s):  
Yi-Chieh Lee ◽  
Shu-Wen Lin ◽  
Mao-Yuan Chen ◽  
Sui-Yuan Chang ◽  
Ching-Hua Kuo ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Extended Release ◽  
Virological Outcome ◽  
Hiv 1

scholarly journals Real-Life Outcomes of Maraviroc-Based Regimens in HIV-1-Infected Individuals

2012 ◽  
Vol 12 (1) ◽  
pp. 12-14 ◽  
Author(s):  
Zahir Osman Eltahir Babiker ◽  
Sam Thomas Douthwaite ◽  
Lucy Elizabeth Collier ◽  
Ashley Pennell ◽  
Alison J. Uriel ◽  
...  
Keyword(s):  
Real Life ◽  
Life Outcomes ◽  
Hiv 1

Cerebrospinal fluid exposure to bictegravir/emtricitabine/tenofovir in HIV-1-infected patients with CNS impairment

2021 ◽  
Author(s):  
Thibaut Gelé ◽  
Antoine Chéret ◽  
Alicia Castro Gordon ◽  
Lionelle Nkam ◽  
Valérie Furlan ◽  
...  
Keyword(s):  
Real Life ◽  
Antiretroviral Drugs ◽  
People Living With Hiv ◽  
Hiv Cure ◽  
Crucial Component ◽  
Total Plasma Concentration ◽  
Tenofovir Alafenamide ◽  
Living With Hiv ◽  
Csf Concentration ◽  
Hiv 1

Abstract Objectives The penetration of antiretroviral drugs into deep compartments, such as the CNS, is a crucial component of strategies towards an HIV cure. This study aimed to determine CSF concentrations of bictegravir, emtricitabine and tenofovir in patients with HIV-related CNS impairment (HCI) enrolled in a real-life observational study. Methods Patients with HCI treated by optimized ART, including bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) for at least 1 month were enrolled. Plasma and CSF concentrations were measured by quality control-validated assays (LC-MS/MS). The inhibitory quotient (IQARV) was calculated as the ratio of unbound (bictegravir) or total (emtricitabine and tenofovir) concentration to half (or 90%) maximal inhibitory concentration for bictegravir (or emtricitabine and tenofovir). All numerical variables are expressed as median (range). Results Twenty-four patients (nine women) were enrolled. The age was 45 (26–68) years. Unbound bictegravir and total emtricitabine and tenofovir CSF concentrations were 4.4 (1.6–9.6), 84.4 (28.6–337.4) and 1.6 (0.7–4.3) ng/mL, respectively. The unbound bictegravir CSF fraction was 34% (15%–82%) versus 0.33% (0.11%–0.92%) in plasma. Three patients had an IQARV above unity for the three antiretrovirals. Factors positively associated with the CSF concentration (unbound for bictegravir) were age and total plasma concentration for the three antiretrovirals. Patients aged over 51 years had higher CSF concentrations (unbound for bictegravir). Conclusions We observed low CSF exposure to bictegravir, emtricitabine and tenofovir. These results suggest that BIC/FTC/TAF should be used with caution as first-line treatment for people living with HIV with HCI under 51 years of age.

Trends in drug resistance-associated mutations in a real-life cohort of Italian patients infected with HIV-1

2015 ◽  
Vol 3 (4) ◽  
pp. 267-272 ◽  
Author(s):  
Claudia Montagna ◽  
Laura Mazzuti ◽  
Francesca Falasca ◽  
Paola Maida ◽  
Mauro Bucci ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Real Life ◽  
Hiv 1
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