VIRO-immunological response of drug-naive HIV-1-infected patients starting a first-line regimen with viraemia >500,000 copies/ml in clinical practice

Maria Mercedes Santoro, Domenico Di Carlo, Daniele Armenia, Mauro Zaccarelli, Carmela Pinnetti, Manuela Colafigli, Francesca Prati, Andrea Boschi, Anna Maria Degli Antoni, Filippo Lagi, Laura Sighinolfi, Cristina Gervasoni, Massimo Andreoni, Andrea Antinori, Cristina Mussini, Carlo Federico Perno, Vanni Borghi, Gaetana Sterrantino

Research output: Contribution to journalArticle

Abstract

Background: Virological success (VS) and immuno-a PI-regimen plus an integrase inhibitor (PI+INI-group; logical reconstitution (IR) of antiretroviral-naive HIV-n=63 [14.7%]). 1-infected patients with pre-therapy viral load (VL) Patients in the PI-group showed the lowest probability >500,000 copies/ml was assessed after 12 months of of VS (PI-group: 72.4%; NNRTI-group: 75.5%; PI+INI-treatment according to initial drug-class regimens. group: 81.0%; P<0.0001). By Cox regression, patients in Methods: An observational multicentre retrospective PI+INI and NNRTI-groups showed a higher adjusted haz-study was performed. VS was defined as the first VL <50 ard ratio (95% CI) of VS compared to those in the PI-copies/ml from treatment start. IR was defined as an group (PI+INI-group: 1.48 [1.08, 2.03]; P=0.014; NNRTI-increase of at least 150 CD4+ T-lymphocytes from treat-group: 1.37 [1.06-1.78]; P=0.015). ment start. Survival analysis was used to estimate the The probability of IR was 76.2%, and was similar among probability and predictors of VS and IR by 12 months of groups. Patients with AIDS showed a lower adjusted haz-therapy. ard ratio (95% CI) of IR compared to non-AIDS presenters Results: 428 HIV-1-infected patients were analysed. (0.70 [0.54, 0.90]; P=0.005). Patients were grouped according to the different first-Conclusions: In this multicentre retrospective study, line drug-classes used: a non-nucleoside reverse tran-patients with viraemia >500,000 copies/ml who start scriptase inhibitor (NNRTI) plus two nucleoside reverse a first-line regimen containing PI+INI or NNRTI yield transcriptase inhibitors (NRTIs; NNRTI-group; n=105 a better VS compared to those receiving a PI-based [24.5%]); a protease inhibitor (PI) plus two NRTIs (PI-regimen. group; n=260 [60.8%]); a four-drug regimen containing a PI-regimen plus an integrase inhibitor (PI+INI-group; n=63 [14.7%]). Patients in the PI-group showed the lowest probability of VS (PI-group: 72.4%; NNRTI-group: 75.5%; PI+INIgroup: 81.0%; P0.0001). By Cox regression, patients in PI+INI and NNRTI-groups showed a higher adjusted hazard ratio (95% CI) of VS compared to those in the PIgroup (PI+INI-group: 1.48 [1.08, 2.03]; P=0.014; NNRTIgroup: 1.37 [1.06-1.78]; P=0.015). The probability of IR was 76.2%, and was similar among groups. Patients with AIDS showed a lower adjusted hazard ratio (95% CI) of IR compared to non-AIDS presenters (0.70 [0.54, 0.90]; P=0.005). Conclusions: In this multicentre retrospective study, patients with viraemia >500,000 copies/ml who start a first-line regimen containing PI+INI or NNRTI yield a better VS compared to those receiving a PI-based regimen.

Original languageEnglish
Pages (from-to)249-257
Number of pages9
JournalAntiviral Therapy
Volume23
Issue number3
DOIs
Publication statusPublished - Jan 1 2018

    Fingerprint

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Santoro, M. M., Carlo, D. D., Armenia, D., Zaccarelli, M., Pinnetti, C., Colafigli, M., Prati, F., Boschi, A., Degli Antoni, A. M., Lagi, F., Sighinolfi, L., Gervasoni, C., Andreoni, M., Antinori, A., Mussini, C., Perno, C. F., Borghi, V., & Sterrantino, G. (2018). VIRO-immunological response of drug-naive HIV-1-infected patients starting a first-line regimen with viraemia >500,000 copies/ml in clinical practice. Antiviral Therapy, 23(3), 249-257. https://doi.org/10.3851/IMP319