TY - JOUR
T1 - Evolution of blood-associated HIV-1 DNA levels after 48 weeks of switching to atazanavir/ritonavir+lamivudine dual therapy versus continuing triple therapy in the randomized AtLaS-M trial
AU - Cauda, Roberto
AU - Di Giambenedetto, Simona
AU - Lombardi, Francesca
AU - Belmonti, Simone
AU - Gagliardini, Roberta
AU - Fabbiani, Massimiliano
AU - De Luca, Andrea
AU - Quiros-Roldan, Eugenia
AU - Latini, Alessandra
AU - Castagna, Antonella
AU - D'Ettorre, Gabriella
AU - Giacometti, Andrea
AU - Di Pietro, Massimo
AU - Mughini, Maria Teresa
AU - Grima, Pierfrancesco
AU - Viscoli, Claudio
AU - Manconi, Paolo Emilio
AU - Puoti, Massimo
AU - Galli, Massimo
AU - Viale, Pierluigi
AU - Gori, Andrea
AU - Rizzardini, Giuliano
AU - Mineo, Maurizio
AU - Antinori, Andrea
AU - Petrosillo, Nicola
AU - Vullo, Vincenzo
AU - Mura, Maria Stella
AU - Caramello, Pietro
AU - Scotton, Pier Giorgio
AU - Concia, Ercole
AU - Lazzarin, Adriano
AU - Francisci, Daniela
AU - Sacchini, Daria
PY - 2017
Y1 - 2017
N2 - Abstract
OBJECTIVES:
The AtLaS-M randomized trial showed that in patients with HIV-1 RNA <50 copies/mL on atazanavir/ritonavir + two NRTIs, switching to a dual therapy with atazanavir/ritonavir+lamivudine had superior efficacy as compared with continuing the previous triple therapy. This substudy was designed to evaluate at 48 weeks the impact of the dual therapy versus the three-drug atazanavir/ritonavir-based therapy on the HIV-1 cellular reservoir as reflected by the quantification of blood-associated HIV-1 DNA levels.
METHODS:
In a representative subset of 201 of 266 randomized patients (104 in the dual-therapy arm and 97 in the triple-therapy arm) total HIV-1 DNA levels in whole blood at baseline and after 48 weeks and factors associated with the HIV-1 DNA levels were evaluated.
RESULTS:
The mean baseline HIV-1 DNA levels (2.47 log 10 copies/10 6 leucocytes) were comparable between arms. A significant mean decrease between baseline and week 48 was observed: -0.069 log 10 copies/10 6 leucocytes in the dual-therapy arm ( P = 0.046) and -0.078 in the triple-therapy arm ( P = 0.011); the mean difference between arms was -0.009 ( P = 0.842). Nadir CD4 count was inversely correlated with baseline HIV-1 DNA ( P = 0.009); longer duration of ART and lower nadir CD4 correlated with a less prominent HIV-1 DNA decrease (both P < 0.005). Higher baseline HIV-1 DNA was associated with residual viraemia at week 48 ( P = 0.031).
CONCLUSIONS:
When compared with continuing three-drug therapy, atazanavir/ritonavir+lamivudine dual therapy resulted in a similar decline in HIV-1 DNA levels in patients with sustained virological suppression. These data support the safety of this simplified treatment strategy in terms of its effect on the cellular HIV-1 reservoir
AB - Abstract
OBJECTIVES:
The AtLaS-M randomized trial showed that in patients with HIV-1 RNA <50 copies/mL on atazanavir/ritonavir + two NRTIs, switching to a dual therapy with atazanavir/ritonavir+lamivudine had superior efficacy as compared with continuing the previous triple therapy. This substudy was designed to evaluate at 48 weeks the impact of the dual therapy versus the three-drug atazanavir/ritonavir-based therapy on the HIV-1 cellular reservoir as reflected by the quantification of blood-associated HIV-1 DNA levels.
METHODS:
In a representative subset of 201 of 266 randomized patients (104 in the dual-therapy arm and 97 in the triple-therapy arm) total HIV-1 DNA levels in whole blood at baseline and after 48 weeks and factors associated with the HIV-1 DNA levels were evaluated.
RESULTS:
The mean baseline HIV-1 DNA levels (2.47 log 10 copies/10 6 leucocytes) were comparable between arms. A significant mean decrease between baseline and week 48 was observed: -0.069 log 10 copies/10 6 leucocytes in the dual-therapy arm ( P = 0.046) and -0.078 in the triple-therapy arm ( P = 0.011); the mean difference between arms was -0.009 ( P = 0.842). Nadir CD4 count was inversely correlated with baseline HIV-1 DNA ( P = 0.009); longer duration of ART and lower nadir CD4 correlated with a less prominent HIV-1 DNA decrease (both P < 0.005). Higher baseline HIV-1 DNA was associated with residual viraemia at week 48 ( P = 0.031).
CONCLUSIONS:
When compared with continuing three-drug therapy, atazanavir/ritonavir+lamivudine dual therapy resulted in a similar decline in HIV-1 DNA levels in patients with sustained virological suppression. These data support the safety of this simplified treatment strategy in terms of its effect on the cellular HIV-1 reservoir
KW - antiretroviral agents
KW - dna level
KW - dual therapy
KW - hiv
KW - antiretroviral agents
KW - dna level
KW - dual therapy
KW - hiv
UR - http://hdl.handle.net/10807/102550
U2 - 10.1093/jac/dkx068
DO - 10.1093/jac/dkx068
M3 - Article
SP - N/A-N/A
JO - Journal of Antimicrobial Chemotherapy
JF - Journal of Antimicrobial Chemotherapy
SN - 0305-7453
ER -