Durability of lopinavir/ritonavir monotherapy in individuals with viral load ≤50 copies/ml in an observational setting

Antonella D Arminio Monforte, Nicola Gianotti, Alessandro Cozzi-Lepri, Carmela Pinnetti, Massimo Andreoni, Giovanni Di Perri, Massimo Galli, Andrea Poli, Andrea Costantini, Giancarlo Orofino, Franco Maggiolo, Giovanni Mazzarello, Benedetto Maurizio Celesia, Filippo Luciani, Adriano Lazzarin, Laura Sighinolfi, Giuliano Rizzardini, Paolo Bonfanti, Carlo Federico Perno, Andrea Antinori

Research output: Contribution to journalArticle

Abstract

Background: The main objective is to evaluate the efficacy and durability of lopinavir-ritonavir monotherapy (LPV/r-MT) in virologically controlled HIV-positive individuals switching from combination antiretroviral therapy (cART). Methods: Criteria to be included in this observational study were to have initiated for the first time LPV/r-MT after ≥2 consecutive HIV RNA≤50 copies/ml achieved on a ≥3-drug-including regimen. The main end points were time to virological rebound (VR; defined in two ways: time of first of two consecutive viral load [VL]>50 and >200 copies/ml), time to discontinuation/intensification and time to experience either a single VL>200 copies/ml or discontinuation/intensification (treatment failure [TF]). Individuals' follow-up accrued from the date of starting LPV/r-MT to event or last available VL. Kaplan-Meier curves and Cox regression analyses were used. Results: A total of 228 individuals were included: median age 46 years (IQR 40-50), 36% females, 36% intravenous drug users and 25% HCV-coinfected. Median CD4+ T-cell count at nadir was 215 cell/mm3 (IQR 116-336) and at baseline was 615 cell/mm3 (IQR 436-768). By 36 months after switching to LPV/r-MT, the proportion of individuals with VR (confirmed VL>200 copies/ml) was 11% and with TF was 35%. In the multivariable Cox model the factors associated with a lower risk of TF was the duration of viral suppression

Original languageEnglish
Pages (from-to)319-324
Number of pages6
JournalAntiviral Therapy
Volume19
Issue number3
DOIs
Publication statusPublished - 2014

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases
  • Medicine(all)

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    Monforte, A. D. A., Gianotti, N., Cozzi-Lepri, A., Pinnetti, C., Andreoni, M., Di Perri, G., Galli, M., Poli, A., Costantini, A., Orofino, G., Maggiolo, F., Mazzarello, G., Celesia, B. M., Luciani, F., Lazzarin, A., Sighinolfi, L., Rizzardini, G., Bonfanti, P., Perno, C. F., & Antinori, A. (2014). Durability of lopinavir/ritonavir monotherapy in individuals with viral load ≤50 copies/ml in an observational setting. Antiviral Therapy, 19(3), 319-324. https://doi.org/10.3851/IMP2687