| Autor: |
Antoine Chéret, Rebecca Bauer, Vincent Meiffrédy, Pauline Lopez, Faïza Ajana, Karine Lacombe, Philippe Morlat, Caroline Lascoux, Jacques Reynes, Ruxandra Calin, Sylvie Abel, Cécile Goujard, Christine Rouzioux, Véronique Avettand-Fenoel, Laurence Meyer |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
The Journal of antimicrobial chemotherapy. 77(9) |
| ISSN: |
1460-2091 |
| Popis: |
Background Whether integrase strand transfer inhibitors (INSTIs) can decrease HIV-1 DNA levels more rapidly than boosted PIs during primary HIV-1 infection (PHI) is unknown. We hypothesized that once-daily dolutegravir/tenofovir/emtricitabine could reduce the viral reservoir through rapid viral replication control further than once-daily darunavir/cobicistat/tenofovir/emtricitabine. Methods The OPTIPRIM2-ANRS 169 study was a randomized (1:1), open-label, multicentre trial in adults with ≤5 or ≤3 HIV antibodies detected, respectively, by western blot or immunoblot in the last 10 days. The primary endpoint was total HIV-1 DNA levels in PBMCs at Week 48 (W48) adjusted for baseline levels. The main secondary endpoint was HIV-1 RNA level decrease. Results Between April 2017 and August 2018, 101 patients were included from 31 hospitals. Most patients were men (93%), the median age was 36 years and 17% were Fiebig stage ≤3. The median (IQR) plasma HIV-1 RNA and DNA levels were, respectively, 5.8 (5.0–6.6) and 3.87 (3.52–4.15) log10 copies/million PBMCs. The median (IQR) decreases in HIV-1 DNA levels at W48 were −1.48 (−1.74 to −1.06) and −1.39 (−1.55 to −0.98) log10 copies/million PBMCs in the dolutegravir and darunavir/cobicistat groups, respectively (P = 0.52). Plasma HIV-1 RNA levels were Conclusions Dolutegravir-based and darunavir-based regimens initiated during PHI strongly and similarly decreased the blood reservoir size. Considering the rapid viral suppression during a period of high HIV-1 transmission risk, dolutegravir-based regimens are a major first-line option. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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