Information de reference pour ce titreAccession Number: | 00004548-201703000-00029.
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Author: | Armenia, D.; Di Carlo, D.; Calcagno, A.; Vendemiati, G.; Forbici, F.; Bertoli, A.; Berno, G.; Carta, S.; Continenza, F.; Fedele, V.; Bellagamba, R.; Cicalini, S.; Ammassari, A.; Libertone, R.; Zaccarelli, M.; Ghisetti, V.; Andreoni, M.; Ceccherini-Silberstein, F.; Bonora, S.; Di Perri, G.; Antinori, A.; Perno, C. F.; Santoro, M. M.
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Institution: | (1)Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy (2)Division of Infectious Diseases, University of Turin, Turin, Italy (3)Antiretroviral Drug Monitoring Laboratory, National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy (4)Infectious Diseases Division, National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy (5)Systems Medicine, University of Rome Tor Vergata, Rome, Italy
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Title: | |
Source: | Journal of Antimicrobial Chemotherapy. 72(3):855-865, March 01, 2017.
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Abstract: | Objectives: To evaluate the maintenance of virological suppression (VS) in antiretroviral-treated HIV-1-suppressed patients switching to a tenofovir/emtricitabine/rilpivirine (TDF/FTC/RPV) single-tablet regimen, by considering pre-existent resistance (pRes).
Methods: pRes was evaluated according to resistance on all previous plasma genotypic resistance tests. Probability and predictors of virological rebound (VR) were evaluated.
Results: Three hundred and nine patients were analysed; 5.8% of them showed resistance to both NRTIs and NNRTIs, while 12.6% showed resistance to only one of these drug classes. By 72 weeks, the probability of VR was 11.3%. A higher probability of VR was found in the following groups: (i) patients with NRTI + NNRTI pRes compared with those harbouring NRTI or NNRTI pRes and with those without reverse transcriptase inhibitor pRes (39.2% versus 11.5% versus 9.4%, P < 0.0001); (ii) patients with a virus with full/intermediate resistance to both tenofovir/emtricitabine and rilpivirine compared with those having a virus with full/intermediate resistance to tenofovir/emtricitabine or rilpivirine and those having a virus fully susceptible to TDF/FTC/RPV (36.4% versus 17.8% versus 9.7%, P < 0.001); and (iii) patients with pre-therapy viraemia >500 000 copies/mL compared with those with lower viraemia levels (>500 000: 16.0%; 100 000-500 000: 9.3%; <100 000 copies/mL: 4.8%, P = 0.009). pRes and pre-therapy viraemia >500 000 copies/mL were independent predictors of VR by multivariable Cox regression.
Conclusions: TDF/FTC/RPV as a treatment simplification strategy shows a very high rate of VS maintenance. The presence of pRes to both NRTIs and NNRTIs and a pre-therapy viraemia >500 000 copies/mL are associated with an increased risk of VR, highlighting the need for an accurate selection of patients before simplification.
(C) British Society for Antimicrobial Chemotherapy 2017. Published by Oxford University Press. All rights reserved.
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References: | 1. WHO. Guidelines 2016. http://apps.who.int/iris/bitstre...- ouverture dans une nouvelle fenêtre.
2. Abers MS, Shandera WX, Kass JS. Neurological and psychiatric adverse effects of antiretroviral drugs. CNS Drugs2014; 28: 131-45.
3. de Bethune MP. Non-nucleoside reverse transcriptase inhibitors (NNRTIs), their discovery, development, and use in the treatment of HIV-1 infection: a review of the last 20 years (1989-2009). Antiviral Res2010; 85: 75-90.
4. Aldir I, Horta A, Serrado M. Single-tablet regimens in HIV: does it really make a difference? Curr Med Res Opin 2014; 30: 89-97.
5. Nelson MR, Elion RA, Cohen CJ . Rilpivirine versus efavirenz in HIV-1-infected subjects receiving emtricitabine/tenofovir DF: pooled 96-week data from ECHO and THRIVE studies. HIV Clin Trials2013; 14: 81-91.
6. Porter DP, Toma J, Tan Y . Clinical outcomes of virologically-suppressed patients with pre-existing HIV-1 drug resistance mutations switching to rilpivirine/emtricitabine/tenofovir disoproxil fumarate in the SPIRIT study. HIV Clin Trials2016; 17: 29-37.
7. Porter DP, Kulkarni R, Fralich T . 96-week resistance analyses of the STaR study: rilpivirine/emtricitabine/tenofovir DF versus efavirenz/emtricitabine/tenofovir DF in antiretroviral-naive, HIV-1-infected subjects. HIV Clin Trials2015; 16: 30-8.
8. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents. Department of Health and Human Service (DHHS). https://aidsinfo.nih.gov/content...- ouverture dans une nouvelle fenêtre.
9. EACS. EACS Guidelines Version 8.0. http://- ouverture dans une nouvelle fenêtre http://www.eacsociety.org/files/...- ouverture dans une nouvelle fenêtre.
10. Gunthard HF, Aberg JA, Eron JJ . Antiretroviral treatment of adult HIV infection: 2014 recommendations of the International Antiviral Society-USA Panel. JAMA2014; 312: 410-25.
11. Gantner P, Reinhart S, Partisani M . Switching to emtricitabine, tenofovir and rilpivirine as single tablet regimen in virologically suppressed HIV-1-infected patients: a cohort study. HIV Med2015; 16: 132-6.
12. Gazaignes S, Resche-Rigon M, Gatey C . Efficacy and safety of a switch to rilpivirine-based regimens in treatment-experienced HIV-1-infected patients: a cohort study. Antivir Ther (Lond)2015; 21: 329-36.
13. Santoro MM, Armenia D, Alteri C . Impact of pre-therapy viral load on virological response to modern first-line HAART. Antivir Ther (Lond)2013; 18: 867-76.
14. Khatchatourian M, Hanf T, Jovelin . Impact of baseline viral load, time to viral suppression, and drug class on virologic rebound. In: Abstracts of the Fifteenth European AIDS Conference, Barcelona, Spain, 2015. Abstract PS10/1. European AIDS Clinical Society, Brussels, Belgium.
15. Farmer A, Wang X, Ganesan A . Factors associated with HIV viral load 'blips' and the relationship between self-reported adherence and efavirenz blood levels on blip occurrence: a case-control study. AIDS Res Ther2016; 13: 16.
16. Santoro MM, Fabeni F, Armenia D . Reliability and clinical relevance of the HIV-1 drug resistance test in patients with low viremia levels. Clin Infect Dis2014; 58: 1156-64.
17. Milia MG, Allice T, Gregori G . Magnetic-silica based nucleic acid extraction for human immunodeficiency virus type-1 drug-resistance testing in low viremic patients. J Clin Virol2010; 47: 8-12.
18. Wensing AM, Calvez V, Gunthard HF . 2015 update of the drug resistance mutations in HIV-1. Top Antivir Med2015; 23: 132-41.
19. Grennan JT, Loutfy MR, Su D . Magnitude of virologic blips is associated with a higher risk for virologic rebound in HIV-infected individuals: a recurrent events analysis. J Infect Dis2012; 205: 1230-8.
20. McCracken B, Hyun S. On the comparison of two survival functions. USC Upstate Stud Res J2010; 3: 39.
21. Palella FJ Jr, Fisher M, Tebas P . Simplification to rilpivirine/emtricitabine/tenofovir disoproxil fumarate from ritonavir-boosted protease inhibitor antiretroviral therapy in a randomized trial of HIV-1 RNA-suppressed participants. AIDS2014; 28: 335-44.
22. Cazanave C, Reigadas S, Mazubert C . Switch to rilpivirine/emtricitabine/tenofovir single-tablet regimen of human immunodeficiency virus-1 RNA-suppressed patients, Agence Nationale de Recherches sur le SIDA et les Hepatites Virales CO3 Aquitaine Cohort, 2012-2014. Open Forum Infect Dis2015; 2: ofv018.
23. Allavena C, Dailly E, Reliquet V . Switching from tenofovir/emtricitabine and nevirapine to a tenofovir/emtricitabine/rilpivirine single-tablet regimen in virologically suppressed, HIV-1-infected subjects. J Antimicrob Chemother2014; 69: 2804-8.
24. Reuman EC, Rhee SY, Holmes SP . Constrained patterns of covariation and clustering of HIV-1 non-nucleoside reverse transcriptase inhibitor resistance mutations. J Antimicrob Chemother2010; 65: 1477-85.
25. Rokx C, Verbon A, Rijnders BJ. Successful switch to rilpivirine/tenofovir/emtricitabine in HIV-1-infected patients with an isolated K103N mutation acquired during prior nonnucleoside reverse transcriptase inhibitor therapy. HIV Med2014; 15: 611-4.
26. Ray AS, Fordyce MW, Hitchcock MJ. Tenofovir alafenamide: a novel prodrug of tenofovir for the treatment of human immunodeficiency virus. Antiviral Res2016; 125: 63-70.
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Language: | English.
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Document Type: | Original research.
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Journal Subset: | Clinical Medicine. Life & Biomedical Sciences. Pharmacology.
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ISSN: | 0305-7453
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NLM Journal Code: | hd7, 7513617
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DOI Number: | https://dx.doi.org/10.1093/jac/d...- ouverture dans une nouvelle fenêtre
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