Virological Outcome Measures During Analytical Treatment Interruptions in Chronic HIV-1-Infected Patients
Por:
Feher, C, Leal, L, Plana, M, Climent, N, Guardo, AC, Martinez, E, Castro, P, Diaz-Brito, V, Mothe, B, De Quiros, JCLB, Gatell, JM, Aloy, P and Garcia, F
Publicada:
1 dic 2019
Ahead of Print:
3 nov 2019
Resumen:
Background. Analytical treatment interruptions (ATIs) 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. We conducted 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. The set point was lower than baseline VL (median delta set point, -0.26; P < .001). This difference was >1 log10 copies/mL in 13.9% of the cases. The median TtR was 2 weeks; no patients had an undetectable VL at week 12. The 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.
Filiaciones:
Feher, C:
Barcelona Inst Sci & Technol, Inst Res Biomed IRB Barcelona, Barcelona, Spain
Univ Barcelona, Hosp Clin Barcelona, HIVACAT, Infect Dis Dept, Barcelona, Spain
Univ Barcelona, Hosp Clin Barcelona, August Pi i Sunyer Biomed Res Inst IDIBAPS, HIVACAT,AIDS Res Grp,Retrovirol & Viral Immunopat, Barcelona, Spain
Leal, L:
Univ Barcelona, Hosp Clin Barcelona, HIVACAT, Infect Dis Dept, Barcelona, Spain
Univ Barcelona, Hosp Clin Barcelona, August Pi i Sunyer Biomed Res Inst IDIBAPS, HIVACAT,AIDS Res Grp,Retrovirol & Viral Immunopat, Barcelona, Spain
Plana, M:
Univ Barcelona, Hosp Clin Barcelona, August Pi i Sunyer Biomed Res Inst IDIBAPS, HIVACAT,AIDS Res Grp,Retrovirol & Viral Immunopat, Barcelona, Spain
Climent, N:
Univ Barcelona, Hosp Clin Barcelona, August Pi i Sunyer Biomed Res Inst IDIBAPS, HIVACAT,AIDS Res Grp,Retrovirol & Viral Immunopat, Barcelona, Spain
Guardo, AC:
Univ Barcelona, Hosp Clin Barcelona, August Pi i Sunyer Biomed Res Inst IDIBAPS, HIVACAT,AIDS Res Grp,Retrovirol & Viral Immunopat, Barcelona, Spain
Martinez, E:
Univ Barcelona, Hosp Clin Barcelona, HIVACAT, Infect Dis Dept, Barcelona, Spain
Univ Barcelona, Hosp Clin Barcelona, August Pi i Sunyer Biomed Res Inst IDIBAPS, HIVACAT,AIDS Res Grp,Retrovirol & Viral Immunopat, Barcelona, Spain
Castro, P:
Univ Barcelona, Hosp Clin Barcelona, HIVACAT, Infect Dis Dept, Barcelona, Spain
Univ Barcelona, Hosp Clin Barcelona, August Pi i Sunyer Biomed Res Inst IDIBAPS, HIVACAT,AIDS Res Grp,Retrovirol & Viral Immunopat, Barcelona, Spain
Hosp Clin Barcelona, Med Intens Care Unit, Barcelona, Spain
Diaz-Brito, V:
Univ Barcelona, Hosp Clin Barcelona, HIVACAT, Infect Dis Dept, Barcelona, Spain
:
irsiCaixa AIDS Res Inst, Badalona, Spain
Hosp Badalona Germans Trias & Pujol, Infect Dis Dept, Badalona, Spain
Cent Univ Catalonia, Univ Vic, Vic, Spain
De Quiros, JCLB:
Hosp Gen Univ Gregorio Maranon, HIV Infect Dis Unit, Madrid, Spain
Inst Invest Sanitaria Gregorio Maranon, Madrid, Spain
Gatell, JM:
Univ Barcelona, Hosp Clin Barcelona, HIVACAT, Infect Dis Dept, Barcelona, Spain
Univ Barcelona, Hosp Clin Barcelona, August Pi i Sunyer Biomed Res Inst IDIBAPS, HIVACAT,AIDS Res Grp,Retrovirol & Viral Immunopat, Barcelona, Spain
ViiV Healthcare, Tres Cantos, Spain
Aloy, P:
Barcelona Inst Sci & Technol, Inst Res Biomed IRB Barcelona, Barcelona, Spain
Inst Catalana Recerca & Estudis Avancats, Barcelona, Spain
Garcia, F:
Univ Barcelona, Hosp Clin Barcelona, HIVACAT, Infect Dis Dept, Barcelona, Spain
Univ Barcelona, Hosp Clin Barcelona, August Pi i Sunyer Biomed Res Inst IDIBAPS, HIVACAT,AIDS Res Grp,Retrovirol & Viral Immunopat, Barcelona, Spain
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