Refining criteria for selecting candidates for a safe lopinavir/ritonavir or darunavir/ritonavir monotherapy in HIV-infected virologically suppressed patients

N Gianotti, A Cozzi-Lepri, A Antinori, A Castagna, A De Luca, BM Celesia, M Galli, C Mussini, C Pinnetti, V Spagnuolo, A D'Arminio Monforte, F Ceccherini-Silberstein, M Andreoni, on behalf of Icona Foundation Study, mono-PI/r database Study Cohorts

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: The primary objective of this study was to estimate the incidence of treatment failure (TF) to protease inhibitor monotherapies (PI/r-MT) with lopinavir/ritonavir (LPV/r) or darunavir/ritonavir (DRV/r). Design: A multicenter cohort of HIV-infected patients with viral load (VL) ≤50 copies/mL, who underwent a switch from any triple combination therapy to PI/r-MT with either LPV/r or DRV/r. Methods: VL was assessed in each center according to local procedures. Residual viremia was defined by any HIV-RNA value detectable below 50 copies/mL by a Real-Time PCR method. Standard survival analysis was used to estimate the rate of TF (defined by virological failure or interruption of monotherapy or reintroduction of combination therapy). A multivariable Cox regression analysis with automatic stepwise procedures was used to identify factors independently associated with TF among nadir and baseline CD4+ counts, residual viremia, time spent with 100 cells/μL) and residual viremia (aHR = 1.48 [95% CI: 1.01-2.17] vs. undetectable VL) were independently associated to TF. Conclusions: Residual viremia and nadir CD4+ counts
Original languageEnglish
Article numbere0171611
JournalPLoS One
Volume12
Issue number2
DOIs
Publication statusPublished - 2017

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