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

Roberto Cauda, Simona Di Giambenedetto, Francesca Lombardi, Simone Belmonti, Roberta Gagliardini, Massimiliano Fabbiani, Andrea De Luca, Eugenia Quiros-Roldan, Alessandra Latini, Antonella Castagna, Gabriella D'Ettorre, Andrea Giacometti, Massimo Di Pietro, Maria Teresa Mughini, Pierfrancesco Grima, Claudio Viscoli, Paolo Emilio Manconi, Massimo Puoti, Massimo Galli, Pierluigi VialeAndrea Gori, Giuliano Rizzardini, Maurizio Mineo, Andrea Antinori, Nicola Petrosillo, Vincenzo Vullo, Maria Stella Mura, Pietro Caramello, Pier Giorgio Scotton, Ercole Concia, Adriano Lazzarin, Daniela Francisci, Daria Sacchini

Risultato della ricerca: Contributo in rivistaArticolo in rivista

20 Citazioni (Scopus)

Abstract

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
Lingua originaleEnglish
pagine (da-a)N/A-N/A
RivistaJournal of Antimicrobial Chemotherapy
DOI
Stato di pubblicazionePubblicato - 2017

Keywords

  • antiretroviral agents
  • dna level
  • dual therapy
  • hiv

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