Virological Outcome Measures During Analytical Treatment Interruptions in Chronic HIV-1-Infected Patients
| Autor: | Juan Carlos López Bernaldo de Quirós, Csaba Fehér, Pedro Castro, Núria Climent, Josep M. Gatell, Esteban Martínez, Felipe García, Lorna Leal, Vicens Díaz-Brito, Patrick Aloy, Montserrat Plana, Alberto C. Guardo, Beatriz Mothe |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty 030106 microbiology Human immunodeficiency virus (HIV) medicine.disease_cause 03 medical and health sciences 0302 clinical medicine Internal medicine vaccine Major Article Medicine 030212 general & internal medicine immune-based therapy Prospective cohort study business.industry Surrogate endpoint Confounding Outcome measures Drug holiday Set point 3. Good health viral load Infectious Diseases Oncology HIV-1 STI business Viral load |
| Zdroj: | Open Forum Infectious Diseases r-IGTP. Repositorio Institucional de Producción Científica del Instituto de Investigación Germans Trias i Pujol instname r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu |
| ISSN: | 2328-8957 |
| Popis: | Background Analytical treatment interruptions (ATI) are essential in research on HIV cure. However, the heterogeneity of virological outcome measures used in different trials hinders the interpretation of the efficacy of different strategies. Methods A retrospective analysis of viral load (VL) evolution in 334 ATI episodes in chronic HIV-1 infected patients collected from 11 prospective studies. Quantitative [baseline VL, set point, delta set point, VL and delta VL at given weeks after ATI, peak VL, delta peak VL, and area under the rebound curve], and temporal parameters [time to rebound (TtR), set point, peak, and certain absolute and relative VL thresholds] were described. Pairwise correlations between parameters were analyzed, and potential confounding factors (sex, age, time of known HIV infection, time on ART, and immunological interventions) were evaluated. Results Set point was lower than baseline VL (median delta set point -0.26. p< 0.001). This difference was >1 log10 copies/mL in 13.9% of the cases. Median TtR was 2 weeks; no patients had undetectable VL at week 12. Median time to set point was 8 weeks: by week 12, 97.4% of the patients had reached the set point. TtR and baseline VL were correlated with most temporal and quantitative parameters. The variables independently associated with TtR were baseline VL and the use of immunological interventions. Conclusions TtR could be an optimal surrogate marker of response in HIV cure strategies. Our results underline the importance of taking into account baseline VL and other confounding factors in the design and interpretation of these studies. |
| Databáze: | OpenAIRE |
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