@article{a4708e24760a4b4a97437c5b78fb9f84,
title = "Predictors of incomplete viral response and virologic failure in patients with acute and early HIV infection. Results of Italian Network of ACuTe HIV InfectiON (INACTION) cohort: HIV Medicine",
abstract = "Objectives: The aim of this study was to evaluate the factors that can influence an incomplete viral response (IVR) after acute and early HIV infection (AEHI). Methods: This was a retrospective, observational study including patients with AEHI (Fiebig stages I–V) diagnosed between January 2008 and December 2014 at 20 Italian centres. IVR was defined by: (1) viral blip (51–1000 HIV-1 RNA copies/mL after achievement of 1000 copies/mL after achievement of 50 copies/mL after 48 weeks on ART or two consecutive HIV-1 RNA levels with ascending trend during ART). Cox regression analysis was used to calculate the hazard ratios (HRs) and 95% confidence intervals (95% CIs) for IVR. Results: In all, 263 patients were studied, 227 (86%) males, with a median [interquartile range (IQR)] age of 38 (30–46) years. During a median follow-up of 13.0 (5.7–31.1) months, 38 (14.4%) had IVR. The presence of central nervous system (CNS) symptoms was linked to a higher risk of IVR (HR = 4.70, 95% CI: 1.56–14.17), while a higher CD4/CD8 cell count ratio (HR = 0.13, 95% CI: 0.03–0.51 for each point increase) and first-line ART with three-drug regimens recommended by current guidelines (HR = 0.40, 95% CI: 0.18–0.91 compared with other regimens including four or five drugs, older drugs or non-standard backbones) were protective against IVR. Conclusions: Patients with lower CD4/CD8 ratio and CNS symptoms could be at a higher risk of IVR after AEHI. The use of recommended ART may be relevant for improving short-term viral efficacy in this group of patients. {\textcopyright} 2020 British HIV Association",
keywords = "acute HIV infection, blip, early antiretroviral treatment, incomplete viral response, virologic failure, abacavir plus lamivudine, atazanavir, CD4 antigen, CD8 antigen, cobicistat, darunavir, dolutegravir, elvitegravir, emtricitabine plus tenofovir alafenamide, raltegravir, rilpivirine, ritonavir, tenofovir disoproxil, adult, antiretroviral therapy, Article, CD4 CD8 ratio, CD8 lymphocyte count, central nervous system, cohort analysis, female, follow up, high risk patient, human, Human immunodeficiency virus 1, major clinical study, male, multicenter study, observational study, practice guideline, priority journal, retrospective study, sustained virologic response, trend study",
author = "L. Taramasso and M. Fabbiani and S. Nozza and {De Benedetto}, I. and E. Bruzzesi and A. Mastrangelo and C. Pinnetti and A. Calcagno and M. Ferrara and G. Bozzi and E. Foc{\`a} and E. Quiros-Roldan and D. Ripamonti and M. Campus and B.M. Celesia and C. Torti and L. Cosco and {Di Biagio}, A. and S. Rusconi and G. Marchetti and C. Mussini and R. Gulminetti and A. Cingolani and G. d{\textquoteright}Ettorre and G. Madeddu and A. Franco and G. Orofino and N. Squillace and A. Muscatello and A. Gori and A. Antinori and G. Tambussi and A. Bandera",
note = "Export Date: 11 March 2021 CODEN: HMIEA Correspondence Address: Taramasso, L.; Infectious Diseases Unit, Italy; email: taramasso.lucia@gmail.com Chemicals/CAS: abacavir plus lamivudine, 852337-16-7; atazanavir, 198904-31-3; cobicistat, 1004316-88-4; darunavir, 206361-99-1, 635728-49-3; dolutegravir, 1051375-16-6, 1051375-19-9, 1172581-47-3; elvitegravir, 697761-98-1; emtricitabine plus tenofovir alafenamide, 731772-56-8; raltegravir, 518048-05-0, 871038-72-1, 889131-29-7; rilpivirine, 500287-72-9, 700361-47-3; ritonavir, 155213-67-5; tenofovir disoproxil, 202138-50-9 Funding details: Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Funding details: Gilead Sciences Funding text 1: The authors are grateful to Elena Cappelletti, Valeria Pastore, Valentina Ferroni, Ilaria Beretta and Teresa Itri for help in data collection. Our thanks go to Effetti Srl (Milan) for administrative support to the INACTION network. The INACTION study group participating physicians and centres are as follows: Andrea Gori, Antonio Muscatello (Ospedale Maggiore Policlinico Milano); Alessandra Bandera (Monza); Giuseppe Tambussi, Silvia Nozza, Marco Ripa, Raffele Dell'Acqua, Elena Bruzzesi, Andrea Mastrangelo (H San Raffaele Milano); Andrea Antinori, Carmela Pinnetti (INMI Spallanzani Roma); Andrea Calcagno, Gianfranco Orofino, Ilaria De Benedetto, Micol Ferrara (Torino); Cristina Mussini, Vanni Borghi, Federica Carli (Modena); Benedetto Maurizio Celesia (Catania); Lucio Cosco, Carlo Torti (Catanzaro); Gabriella D'Ettorre (Umberto I Roma); Antonio Di Biagio (Genova); Emanuele Foc?, Eugenia Quiros-Roland (Brescia); Antonina Franco (Siracusa); Diego Ripamonti, Franco Maggiolo (Bergamo); Roberto Gulminetti, Massimiliano Fabbiani (Pavia); Sandro Piga, Marzia Garau, Marco Campus (Cagliari); Stefano Rusconi, Tiziana Formenti, Arianna Gabrieli, Alessia Lai, Cecilia Bonazzetti, Andrea Giacomelli (H Sacco Milano); Giulia Marchetti, Camilla Tincati (H San Paolo Milano); Antonella Cingolani (H Gemelli Roma); Giordano Madeddu (Sassari). Financial disclosure: This work was supported by unrestricted grants from Gilead Sciences, Milan, Italy, and from ANLAIDS sezione Lombardia, Milan, Italy.",
year = "2020",
doi = "10.1111/hiv.12885",
language = "English",
volume = "21",
pages = "523--535",
journal = "HIV Med.",
issn = "1464-2662",
publisher = "Blackwell Publishing Ltd",
number = "8",
}