Continuous versus intermittent treatment strategies during primary HIV-1 infection: the randomized ANRS INTERPRIM Trial

Autor:	Goujard, Cécile, Emilie, Dominique, Roussillon, Caroline, Godot, Véronique, Rouzioux, Chrisitine, Venet, Alain, Colin, Céline, Pialoux, Gilles, Girard, Pierre-Marie, Boilet, Valérie, Chaix, Marie-Laure, Galanaud, Pierre, Chene, Geneviève, Michelet, Christian
Přispěvatelé:	Service de médecine interne et maladies infectieuses, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Cytokines, chimiokines et immunopathologie, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Epidémiologie et Biostatistique [Bordeaux], Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de Virologie [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Régulation de la réponse immune, infection VIH-1 et autoimmunité, Service des maladies infectieuses et tropicales [CHU Tenon], Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Services des Maladies Infectieuses et Tropicales [CHU Saint-Antoine], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut de recherche en santé, environnement et travail (Irset), Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), French National Agency forResearch on AIDS and ViralHepatitis (ANRS), ANRS-112 INTERPRIM Study Group, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Bicêtre, Centre de recherche en épidémiologie et santé des populations ( CESP ), Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Paris-Sud - Paris 11 ( UP11 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale ( INSERM ), CHU Necker - Enfants Malades [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP), Service des maladies infectieuses et tropicales, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Tenon [APHP], Service des maladies infectieuses et tropicales [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Saint-Antoine [APHP], Institut de recherche, santé, environnement et travail ( Irset ), Université d'Angers ( UA ) -Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -École des Hautes Études en Santé Publique [EHESP] ( EHESP ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ) -Université des Antilles ( UA )
Jazyk:	angličtina
Rok vydání:	2012
Předmět:	CD4-Positive T-Lymphocytes Male antiretroviral treatment MESH : Viral Load CD8-Positive T-Lymphocytes Lymphocyte Activation Polyethylene Glycols MESH: HIV-1 MESH: Recombinant Proteins 0302 clinical medicine Pegylated interferon [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases Immunology and Allergy Medicine MESH : Female MESH : DNA Viral 030212 general & internal medicine MESH: Anti-HIV Agents MESH: Treatment Outcome Response rate (survey) 0303 health sciences MESH: Middle Aged MESH : Acquired Immunodeficiency Syndrome treatment interruption MESH : Polyethylene Glycols virus diseases MESH: CD4-Positive T-Lymphocytes interferon MESH: Follow-Up Studies Middle Aged Viral Load MESH : Adult MESH : CD8-Positive T-Lymphocytes MESH: CD8-Positive T-Lymphocytes Recombinant Proteins 3. Good health [ SDV.MHEP.MI ] Life Sciences [q-bio]/Human health and pathology/Infectious diseases Treatment Outcome Infectious Diseases MESH : CD4-Positive T-Lymphocytes primary infection MESH : Interferon-alpha Female MESH: Interferon-alpha MESH: Viral Load Viral load MESH : HIV-1 medicine.drug Adult Cart medicine.medical_specialty Anti-HIV Agents MESH : Recombinant Proteins MESH : Male MESH : Drug Administration Schedule Immunology CD4-CD8 Ratio Alpha interferon MESH : Treatment Outcome Interferon alpha-2 MESH: Drug Administration Schedule Drug Administration Schedule 03 medical and health sciences Immune system Internal medicine Antiretroviral treatment Humans MESH : Middle Aged MESH: Lymphocyte Activation MESH : Lymphocyte Activation 030304 developmental biology MESH: Acquired Immunodeficiency Syndrome Acquired Immunodeficiency Syndrome MESH: Humans business.industry MESH : Anti-HIV Agents MESH : Humans Interferon-alpha MESH : Follow-Up Studies MESH: Adult MESH: Male Surgery MESH: DNA Viral MESH: Polyethylene Glycols MESH : CD4-CD8 Ratio DNA Viral HIV-1 MESH: CD4-CD8 Ratio business MESH: Female CD8 Follow-Up Studies
Zdroj:	AIDS AIDS, Lippincott, Williams & Wilkins, 2012, 26 (15), pp.1895-905. ⟨10.1097/QAD.0b013e32835844d9⟩ AIDS. Official journal of the international AIDS Society AIDS. Official journal of the international AIDS Society, 2012, 26 (15), pp.1895-905. ⟨10.1097/QAD.0b013e32835844d9⟩ AIDS, Lippincott, Williams & Wilkins, 2012, 26 (15), pp.1895-905. 〈10.1097/QAD.0b013e32835844d9〉
ISSN:	0269-9370 1473-5571
DOI:	10.1097/QAD.0b013e32835844d9⟩
Popis:	International audience; OBJECTIVES: The ANRS-112 INTERPRIM trial assessed whether fixed-cycles of antiretroviral treatment interruption (ART-STI) combined or not with pegylated interferon alpha-2b (peg-IFN) could lower viral load and achieve a healthier immune system in patients diagnosed during primary HIV-1-infection (PHI). DESIGN AND METHODS: Patients were randomized to receive either continuous ART (cART) during 72 weeks, or cART during 36 weeks followed by three ART-STIs, or the same ART-STIs associated with peg-IFN during the first 14 weeks and each interruption (ART-STI-IFN). Treatment was stopped at week 72. Final evaluation was based on plasma HIV-RNA level 6 months after the last treatment interruption. RESULTS: Eighty-seven percent of patients achieved undetectable HIV-RNA at week 32, with no deleterious impact of sequential treatment interruptions (STIs). Viral rebounds during interruptions were lower in the ART-STI-IFN than in the ART-STI group and during the second and third interruptions compared with the first one. However, HIV-RNA levels, CD4 T-cell counts and CD4 T/CD8 T ratios were similar between groups after the 6-month interruption, with a persistent effect on CD4 T cells and total cell-associated HIV-DNA levels. Predictive factors of virological outcome were HIV-RNA and HIV-DNA levels at PHI and HIV-DNA levels at treatment interruption. HIV-specific responses did not differ between strategies and were not associated with outcome. Forty-eight percent of patients experienced treatment resumption during long-term follow-up without difference between groups. CONCLUSION: When initiated during PHI, STIs associated or not with IFN did not result in a different outcome as compared to cART. All regimens showed a high response rate and a sustained immunological benefit after cessation.
Databáze:	OpenAIRE
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