HIV-1 genital shedding in HIV-infected patients randomized to second-line lopinavir/ritonavir monotherapy versus tenofovir/lamivudine/lopinavir/ritonavir
| Autor: | Chureeratana Bowonwattanuwong, Torsak Bunupuradah, Warangkana Munsakul, Supunnee Jirajariyavej, Kiat Ruxrungtham, Apicha Mahanontharit, Jintanat Ananworanich, Jiratchaya Sophonphan, Virat Klinbuayaem, Bernard Hirschel |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Time Factors Tenofovir Anti-HIV Agents Organophosphonates Lopinavir/ritonavir HIV Infections Lopinavir Second line Risk Factors Antiretroviral Therapy Highly Active Medicine Hiv infected patients Humans Pharmacology (medical) Sex organ Genitalia Pharmacology Ritonavir business.industry Adenine virus diseases Lamivudine Viral Load Virology Virus Shedding Infectious Diseases Treatment Outcome HIV-1 Female business medicine.drug Follow-Up Studies |
| Zdroj: | Antiviral therapy. 19(6) |
| ISSN: | 2040-2058 |
| Popis: | Background HIV-1 shedding in genital secretions is associated with HIV transmission risk. Limited data exist on the effect of second-line lopinavir/ritonavir mono-therapy (mLPV/r) on genital secretion of HIV RNA. Methods We measured HIV-1 in genital secretions of HIV-infected adults at time of failure from non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimens and at 48 weeks after being randomized to second-line mLPV/r versus tenofovir/lamivudine/LPV/r (TDF/3TC/LPV/r). Plasma and genital secretion (semen, vaginal swab) HIV RNA was quantified by the CobasAm-pliprep/TaqMan assay. Results Forty enrolled (15 on mLPV/r and 25 on TDF/3TC/LPV/r). Median age was 37.8 years and 35% were male. Median baseline CD4+ T-cell count was 222 cells/mm3, plasma HIV RNA was 4.1 log10 copies/ml and genital secretion HIV RNA was 2.3 log10 copies/ml. At week 48, the proportion of patients with plasma HIV RNA50 copies/ml at week 48 was baseline genital secretion HIV RNA>50 copies/ml ( P=0.049). Conclusions LPV/r either given alone or in combination with TDF/3TC as second-line treatment achieved high genital secretion HIV RNA suppression rate. Genital secretion HIV RNA remained detectable at low levels in one-third of patients with suppressed plasma viraemia. |
| Databáze: | OpenAIRE |
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