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 <50 copies/ml prior to baseline (ARH=0.92; 95% CI 0.85, 0.99; P=0.024, per 6 months longer) and having LPV/r as part of last cART (ARH=0.45; 95% CI 0.21, 0.95; P=0.037). Conclusions: In daily clinical practice, we confirm a relatively safe approach of treatment simplification to LPV-MT in a selected population with long-lasting virological control

Monforte, A., Gianotti, N., Cozzi Lepri, A., Pinnetti, C., Andreoni, M., Di Perri, G., et al. (2014). Durability of lopinavir/ritonavir monotherapy in individuals with viral load ≤50 copies/ml in an observational setting. ANTIVIRAL THERAPY, 19(3), 319-324 [10.3851/IMP2687].

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

Bonfanti, P;GORI, ANDREA
2014

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 <50 copies/ml prior to baseline (ARH=0.92; 95% CI 0.85, 0.99; P=0.024, per 6 months longer) and having LPV/r as part of last cART (ARH=0.45; 95% CI 0.21, 0.95; P=0.037). Conclusions: In daily clinical practice, we confirm a relatively safe approach of treatment simplification to LPV-MT in a selected population with long-lasting virological control
Articolo in rivista - Articolo scientifico
Adult; Anti-HIV Agents; Drug Therapy, Combination; Female; HIV Infections; HIV-1; Hepacivirus; Hepatitis C; Humans; Lopinavir; Male; Middle Aged; Prospective Studies; RNA, Viral; Ritonavir; Substance-Related Disorders; Time Factors; Viral Load; Pharmacology; Pharmacology (medical); Infectious Diseases; Medicine (all)
English
319
324
6
Monforte, A., Gianotti, N., Cozzi Lepri, A., Pinnetti, C., Andreoni, M., Di Perri, G., et al. (2014). Durability of lopinavir/ritonavir monotherapy in individuals with viral load ≤50 copies/ml in an observational setting. ANTIVIRAL THERAPY, 19(3), 319-324 [10.3851/IMP2687].
Monforte, 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; Luciani, F; Lazzarin, A; Sighinolfi, L; Rizzardini, G; Bonfanti, P; Perno, C; Antinori, A; Gori, A
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/99253
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