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Cusato J, Mulasso A, Ferrara M, Manca A, Antonucci M, Accardo G, Palermiti A, Bianco G, Chiara F, Mula J, Maddalone MG, Tettoni MC, Cuomo S, Trevisan G, Bonora S, Di Perri G, Lupo C, Rainoldi A, D’Avolio A. Studying the Changes in Physical Functioning and Oxidative Stress-Related Molecules in People Living with HIV after Switching from Triple to Dual Therapy. Antioxidants (Basel) 2024; 13:518. [PMID: 38790623 PMCID: PMC11117521 DOI: 10.3390/antiox13050518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/19/2024] [Accepted: 04/24/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Physical activity could increase the production of oxidative stress biomarkers, affecting the metabolism and excretion of antiretroviral drugs and, consequently, the clinical outcome. Nowadays, people living with HIV (PLWH) are mostly switching from triple to dual therapy, but no data are available in terms of physical functioning and oxidative stress. The aim of this study was to evaluate if some antioxidant biomarkers and physical functioning tests could be different according to triple or dual antiretroviral therapy. METHODS PLWH were evaluated at baseline (BL), while treated with three drugs, and six months after the switch to dual therapy. Physical functioning was quantified using validated tools. Mitochondrial and cytosol antioxidant molecules were evaluated through liquid chromatography. RESULTS Twenty-five patients were analyzed. A statistically significant difference between triple and dual therapy was found for mitochondrial glutathione, but not for physical tests. Evaluating differences between physically active and inactive individuals, the following statistically significant differences were suggested, considering triple therapy (mitochondrial n-formyl-methionine p = 0.022, triglycerides p = 0.023) and double therapy (mitochondrial glycine p = 0.035, cytosol glutamic acid p = 0.007, cytosol s-adenosylmethionine p = 0.021). CONCLUSIONS For the first time, this study suggests possible differences in terms of antioxidant molecules and physical functioning in PLWH switching from triple to dual therapy.
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Affiliation(s)
- Jessica Cusato
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, 10149 Turin, Italy; (J.C.); (A.P.); (G.B.); (J.M.); (M.G.M.)
| | - Anna Mulasso
- NeuroMuscolarFunction|Research Group, Department of Medical Sciences, University of Turin, 10128 Turin, Italy; (A.M.); (S.C.); (C.L.); (A.R.)
| | - Micol Ferrara
- ASL Città di Torino, Amedeo di Savoia Hospital, 10149 Turin, Italy; (M.F.); (M.A.); (M.C.T.)
| | - Alessandra Manca
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, 10149 Turin, Italy; (J.C.); (A.P.); (G.B.); (J.M.); (M.G.M.)
| | - Miriam Antonucci
- ASL Città di Torino, Amedeo di Savoia Hospital, 10149 Turin, Italy; (M.F.); (M.A.); (M.C.T.)
| | - Guido Accardo
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, 10149 Turin, Italy; (G.A.); (G.T.); (S.B.); (G.D.P.)
| | - Alice Palermiti
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, 10149 Turin, Italy; (J.C.); (A.P.); (G.B.); (J.M.); (M.G.M.)
| | - Gianluca Bianco
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, 10149 Turin, Italy; (J.C.); (A.P.); (G.B.); (J.M.); (M.G.M.)
| | - Francesco Chiara
- Laboratory of Clinical Pharmacology S. Luigi A.O.U., Department of Clinical and Biological Sciences, University of Turin, Regione Gonzole, Orbassano, 10043 Turin, Italy;
| | - Jacopo Mula
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, 10149 Turin, Italy; (J.C.); (A.P.); (G.B.); (J.M.); (M.G.M.)
| | - Maria Grazia Maddalone
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, 10149 Turin, Italy; (J.C.); (A.P.); (G.B.); (J.M.); (M.G.M.)
| | - Maria Cristina Tettoni
- ASL Città di Torino, Amedeo di Savoia Hospital, 10149 Turin, Italy; (M.F.); (M.A.); (M.C.T.)
| | - Simone Cuomo
- NeuroMuscolarFunction|Research Group, Department of Medical Sciences, University of Turin, 10128 Turin, Italy; (A.M.); (S.C.); (C.L.); (A.R.)
| | - Giulia Trevisan
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, 10149 Turin, Italy; (G.A.); (G.T.); (S.B.); (G.D.P.)
| | - Stefano Bonora
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, 10149 Turin, Italy; (G.A.); (G.T.); (S.B.); (G.D.P.)
| | - Giovanni Di Perri
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, 10149 Turin, Italy; (G.A.); (G.T.); (S.B.); (G.D.P.)
| | - Corrado Lupo
- NeuroMuscolarFunction|Research Group, Department of Medical Sciences, University of Turin, 10128 Turin, Italy; (A.M.); (S.C.); (C.L.); (A.R.)
| | - Alberto Rainoldi
- NeuroMuscolarFunction|Research Group, Department of Medical Sciences, University of Turin, 10128 Turin, Italy; (A.M.); (S.C.); (C.L.); (A.R.)
| | - Antonio D’Avolio
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, 10149 Turin, Italy; (J.C.); (A.P.); (G.B.); (J.M.); (M.G.M.)
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Mazouz F, Bertine M, Coppée R, Storto A, Katlama C, Landman R, Cabié A, Peytavin G, Raffi F, Yazdanpanah Y, Descamps D, Joly V, Ghosn J, Charpentier C. Proportion of APOBEC3-induced defective HIV DNA after 1 year of dolutegravir + lamivudine simplification in the ANRS 167 LAMIDOL trial. J Antimicrob Chemother 2023; 78:2995-3002. [PMID: 37930812 DOI: 10.1093/jac/dkad344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 10/11/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Hypermutated viruses induced by APOBEC3 (apolipoprotein B mRNA-editing, enzyme-catalytic, polypeptide-like 3) proteins comprise some of the defective viruses in the HIV reservoir. Here, we assessed the proportion of APOBEC3-induced defective proviruses in HIV-positive patients before and after receiving dolutegravir + lamivudine dual therapy. METHODS PBMCs of virologically suppressed patients enrolled in the ANRS 167 LAMIDOL trial, evaluating a switch from triple therapy to dolutegravir + lamivudine, were collected 8 weeks before (W-8) and 48 weeks after (W48) dual-therapy initiation. The Vif and RT regions were subject to next-generation sequencing. Bioinformatic algorithms were developed to identify APOBEC3-defective sequences and APOBEC3-related drug resistance mutations (APOMuts). All hypermutated sequences and those containing at least one stop codon were considered as defective. RESULTS One hundred and four patients were enrolled (median virological suppression duration: 4.2 years; IQR: 2.0-9.1). Proviral defective reads at W-8 and W48 were detected in Vif in 22% and 29% of patients, respectively, and in RT in 38% and 42% of patients, respectively. At least one APOMut was present in proviruses of 27% and 38% of patients at W-8 and W48, respectively. The ratio of APOMuts/number of potential APOMut sites was significantly higher at W48 (16.5%) than at W-8 (9.8%, P = 0.007). The presence of APOBEC3-defective viruses at W-8 was not associated with HIV total DNA level, nor with the third drug class received prior to switching to dolutegravir + lamivudine, nor with the duration of virological suppression. CONCLUSIONS Whereas no significant change in the proportion of patients with APOBEC3-defective proviruses was evidenced after 1 year of dolutegravir + lamivudine maintenance, enrichment in APOMuts was observed. Further longer-term studies are needed to assess the other forms of defective viruses with dual-therapy.
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Affiliation(s)
- Fella Mazouz
- Service de Virologie, INSERM, IAME, UMR 1137, AP-HP, Hôpital Bichat-Claude Bernard, Université Paris Cité, Paris, France
| | - Mélanie Bertine
- Service de Virologie, INSERM, IAME, UMR 1137, AP-HP, Hôpital Bichat-Claude Bernard, Université Paris Cité, Paris, France
| | - Romain Coppée
- Service de Virologie, INSERM, IAME, UMR 1137, AP-HP, Hôpital Bichat-Claude Bernard, Université Paris Cité, Paris, France
| | - Alexandre Storto
- Service de Virologie, INSERM, IAME, UMR 1137, AP-HP, Hôpital Bichat-Claude Bernard, Université Paris Cité, Paris, France
| | - Christine Katlama
- Service de Maladies Infectieuses et Tropicales, Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris, France
| | - Roland Landman
- Service de Maladies Infectieuses et Tropicales, INSERM, IAME, UMR 1137, AP-HP, Hôpital Bichat-Claude Bernard, Université Paris Cité, Paris, France
| | - André Cabié
- Service de Maladies Infectieuses et Tropicales, CHU Martinique, Fort-de-France, France
| | - Gilles Peytavin
- Service de Pharmacologie, INSERM, IAME, UMR 1137, AP-HP, Hôpital Bichat-Claude Bernard, Université Paris Cité, Paris, France
| | - François Raffi
- Service de Maladies Infectieuses et Tropicales, CHU Hôtel-Dieu, Nantes, France
| | - Yazdan Yazdanpanah
- Service de Maladies Infectieuses et Tropicales, INSERM, IAME, UMR 1137, AP-HP, Hôpital Bichat-Claude Bernard, Université Paris Cité, Paris, France
| | - Diane Descamps
- Service de Virologie, INSERM, IAME, UMR 1137, AP-HP, Hôpital Bichat-Claude Bernard, Université Paris Cité, Paris, France
| | - Véronique Joly
- Service de Maladies Infectieuses et Tropicales, INSERM, IAME, UMR 1137, AP-HP, Hôpital Bichat-Claude Bernard, Université Paris Cité, Paris, France
| | - Jade Ghosn
- Service de Maladies Infectieuses et Tropicales, INSERM, IAME, UMR 1137, AP-HP, Hôpital Bichat-Claude Bernard, Université Paris Cité, Paris, France
| | - Charlotte Charpentier
- Service de Virologie, INSERM, IAME, UMR 1137, AP-HP, Hôpital Bichat-Claude Bernard, Université Paris Cité, Paris, France
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Lambert-Niclot S, Abdi B, Bellet J, Fofana D, De Truchis P, Amat K, Alvarez JC, Surgers L, Allavena C, Zaegell-Faucher O, Morlat P, Palich R, Gibowski S, Costagliola D, Girard PM, Landman R, Assoumou L, Morand-Joubert L. Four days/week antiretroviral maintenance strategy (ANRS 170 QUATUOR): substudies of reservoirs and ultrasensitive drug resistance. J Antimicrob Chemother 2023:7146011. [PMID: 37104815 DOI: 10.1093/jac/dkad119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 04/04/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND In a 4 days/week (4/7 days) maintenance strategy (ANRS-170 QUATUOR trial), the virological impact of an intermittent strategy was assessed by ultrasensitive virological analyses of reservoirs and resistance. METHODS HIV-1 total DNA, ultra-sensitive plasma viral load (USpVL) and semen VL were measured in the first 121 participants. Sanger and ultra-deep sequencing (UDS) were performed on the HIV-1 genome (Illumina technology) according to the ANRS consensus. A generalized estimation equation with a Poisson distribution was used to compare changes in the proportion of residual viraemia, detectable semen HIV RNA and HIV DNA within and between the two groups over time. RESULTS The proportion of participants with residual viraemia at Day 0 (D0) and Week 48 (W48) was 16.7% and 25.0% in the 4/7 days group and 22.4% and 29.7% in the 7/7 days group, respectively (+8.3% versus +7.3%, P = 0.971). The proportion of detectable DNA (>40 copies/106 cells) at D0 and W48 was 53.7% and 57.4% in the 4/7 days group and 56.1% and 51.8% in the 7/7 days group, respectively (+3.7% versus -4.3%, P = 0.358). Semen HIV RNA was detectable (≥100 copies/mL) in 2.2% of participants at D0 and 4.5% at W48 in the 4/7 days group versus 6.1% and 9.1% in the 7/7 days group, respectively (+2.3% versus +3.0%, P = 0.743). Emerging resistance at failure was more frequent in the 4/7 days group detected by Sanger sequencing: 3/6 participants versus 1/4 in the 7/7 days group, and similar with the UDS assay: 5/6 versus 4/4, respectively. CONCLUSIONS These findings support the potency of a 4/7 days maintenance strategy on virological suppression at the reservoirs and emergent resistance level, including minority variants.
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Affiliation(s)
- Sidonie Lambert-Niclot
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), 184 rue du Faubourg Saint-Antoine, 75571 Cedex 12, Paris, France
- AP-HP Hôpital Saint-Antoine, Laboratoire de Virologie, Paris, France
| | - Basma Abdi
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), 184 rue du Faubourg Saint-Antoine, 75571 Cedex 12, Paris, France
- AP-HP Hôpital Pitié-Salpêtrière, Virology Department, Paris, France
| | - Jonathan Bellet
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), 184 rue du Faubourg Saint-Antoine, 75571 Cedex 12, Paris, France
| | - Djeneba Fofana
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), 184 rue du Faubourg Saint-Antoine, 75571 Cedex 12, Paris, France
- AP-HP Hôpital Saint-Antoine, Laboratoire de Virologie, Paris, France
| | - Pierre De Truchis
- Hôpitaux Universitaires Paris-Ile de France-Ouest, Hôpital Raymond Poincaré APHP, Université Versailles-Saint-Quentin, France, Infectious Diseases Department, Garches, France
| | - Karine Amat
- Institut de Médecine et Epidémiologie Appliquée, Hôpital Bichat, Université Paris 7, Paris, France
| | - Jean-Claude Alvarez
- Département de Pharmacologie-Toxicologie, Hôpital R Poincaré APHP, Inserm U-1173, Université Versailles-Saint-Quentin, Garches, France
| | - Laure Surgers
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), 184 rue du Faubourg Saint-Antoine, 75571 Cedex 12, Paris, France
- GHU APHP. Sorbonne Université, Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, F75012, Paris, France
| | | | - Olivia Zaegell-Faucher
- CHU Sainte-Marguerite, Assistance Publique Hôpitaux de Marseille, Infectious Diseases Department, Marseille, France
| | - Philippe Morlat
- Hôpital Saint André, Internal Medicine and Infectious Diseases Department, CHU, Université de Bordeaux, Bordeaux, France
| | - Romain Palich
- AP-HP Hôpital Pitié-Salpêtrière, Infectious Diseases Department, Paris, France
| | | | - Dominique Costagliola
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), 184 rue du Faubourg Saint-Antoine, 75571 Cedex 12, Paris, France
| | - Pierre-Marie Girard
- GHU APHP. Sorbonne Université, Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, F75012, Paris, France
| | - Roland Landman
- Infectious and Tropical Diseases Department, IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, AP-HP, Hôpital Bichat, AP-HP, Infectious and Tropical Diseases, Paris, France
| | - Lambert Assoumou
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), 184 rue du Faubourg Saint-Antoine, 75571 Cedex 12, Paris, France
| | - Laurence Morand-Joubert
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), 184 rue du Faubourg Saint-Antoine, 75571 Cedex 12, Paris, France
- AP-HP Hôpital Saint-Antoine, Laboratoire de Virologie, Paris, France
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Gibas KM, Kelly SG, Arribas JR, Cahn P, Orkin C, Daar ES, Sax PE, Taiwo BO. Two-drug regimens for HIV treatment. Lancet HIV 2022; 9:e868-e883. [PMID: 36309038 PMCID: PMC10015554 DOI: 10.1016/s2352-3018(22)00249-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 08/16/2022] [Accepted: 08/22/2022] [Indexed: 12/05/2022]
Abstract
Combination therapy with three antiretroviral agents has been integral to successful HIV-1 treatment since 1996. Although the efficacy, adverse effects, and toxicities of contemporary three-drug regimens have improved, even the newest therapies have potential adverse effects. The use of two-drug regimens is one way to reduce lifetime exposure to antiretroviral drugs while maintaining the benefits of viral suppression. Multiple large, randomised trials have shown the virological non-inferiority of certain two-drug regimens versus three-drug comparators, including adverse effect differences that reflect known profiles of the antiretroviral drugs in the respective regimens. Two-drug combinations are now recommended in treatment guidelines and include the first long-acting antiretroviral regimen for the treatment of HIV-1. Recommended two-drug regimens differ in their risks for, and factors associated with, virological failure and emergent resistance. The tolerability, safety, metabolic profiles, and drug interactions of two-drug regimens also vary by the constituent drugs. No current two-drug regimen is recommended for people with chronic hepatitis B virus as none include tenofovir. Two-drug regimens have increased options for individualised care.
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Affiliation(s)
- Kevin M Gibas
- Division of Infectious Diseases, Vanderbilt University Medical Center, Vanderbilt University, Nashville, TN, USA
| | - Sean G Kelly
- Division of Infectious Diseases, Vanderbilt University Medical Center, Vanderbilt University, Nashville, TN, USA
| | - Jose R Arribas
- Infectious Diseases Unit, La Paz University Hospital, Hospital La Paz Institute for Health Research, Madrid, Spain; School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Madrid, Spain
| | - Pedro Cahn
- Fundación Huésped, Buenos Aires, Argentina
| | - Chloe Orkin
- Department of Immunobiology, Queen Mary University of London, London, UK
| | - Eric S Daar
- The Lundquist Institute, Harbor University of California, Los Angeles, Torrence, CA, USA
| | - Paul E Sax
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Harvard University, Boston, MA, USA
| | - Babafemi O Taiwo
- Division of Infectious Diseases, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
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Mariaggi AA, Bauer R, Charre C, Gardiennet E, Meiffredy V, Ajana F, Lacombe K, Pialoux G, Cua E, Rouzioux C, Meyer L, Cheret A, Avettand-Fenoel V. HIV-1-RNA and total HIV-1-DNA loads in the genital compartment in men receiving dolutegravir- versus darunavir-based combined ART (cART) regimens during primary HIV infection. J Antimicrob Chemother 2022; 77:735-739. [PMID: 35195692 DOI: 10.1093/jac/dkab427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 10/21/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Dolutegravir is a widespread integrase strand-transfer inhibitor (INSTI) recommended for treatment of primary HIV infection (PHI). PHI is a high-risk stage for sexual transmission because of the high viral load in semen. Yet dolutegravir concentrations in semen are lower than in blood during chronic treatment. OBJECTIVES To compare the kinetics of HIV-RNA and total HIV-DNA in the genital compartment in subjects receiving either tenofovir/emtricitabine/dolutegravir or tenofovir/emtricitabine/darunavir/cobicistat as a first-line combined ART (cART) at the time of PHI. PATIENTS AND METHODS Eighteen subjects receiving tenofovir/emtricitabine/dolutegravir and 19 receiving tenofovir/emtricitabine/darunavir/cobicistat enrolled in the ANRS169 OPTIPRIM-2 trial participated in the genital substudy. RESULTS Between week (W) 0 and W2 HIV-RNA in seminal plasma (SP) decreased by 1 log10 copies/mL. Undetectable SP HIV-RNA was achieved in similar proportions between the two regimens at each timepoint. Overall, eight patients still presented detectable HIV-RNA or HIV-DNA in semen at W48; 15.4% and 28.6% presented detectable HIV-RNA and 9.1% and 14.3% presented detectable HIV-DNA in dolutegravir- and darunavir-based cART groups, respectively, with no significant difference. CONCLUSIONS For the first time, to the best of our knowledge, we showed that a dolutegravir-based regimen initiated as soon as PHI reduces HIV-RNA and HIV-DNA with no difference compared with a control group receiving a darunavir-based regimen. Although the viral purge in semen seems longer after treatment in PHI than CHI, due to high viral loads, early dolutegravir-based treatment initiation permits a major decay of both viral particles and infected cells in semen, efficiently reducing the high risk of transmission during PHI.
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Affiliation(s)
- Alice-Andrée Mariaggi
- Université de Paris, Faculté de Médecine, Paris, France.,INSERM U1016, CNRS UMR8104, Institut Cochin, Paris, France.,AP-HP, Laboratoire de Virologie, CHU Cochin, Paris, France
| | | | - Caroline Charre
- Université de Paris, Faculté de Médecine, Paris, France.,INSERM U1016, CNRS UMR8104, Institut Cochin, Paris, France.,AP-HP, Laboratoire de Virologie, CHU Cochin, Paris, France
| | - Elise Gardiennet
- Université de Paris, Faculté de Médecine, Paris, France.,INSERM U1016, CNRS UMR8104, Institut Cochin, Paris, France
| | | | - Faiza Ajana
- CH Tourcoing, Service de Maladies Infectieuses, Tourcoing, France
| | - Karine Lacombe
- AP-HP, Hôpital Saint Antoine, Service de Maladies Infectieuses et Tropicales, Paris, France.,Sorbonne Université, Faculté de Médecine, Paris, France
| | - Gilles Pialoux
- Sorbonne Université, Faculté de Médecine, Paris, France.,AP-HP, Hôpital Tenon, Service de Maladies Infectieuses et Tropicales, Paris, France
| | - Eric Cua
- CHU de Nice l'Archet, Service de Maladies Infectieuses et Tropicales, Nice, France
| | | | - Laurence Meyer
- INSERM SC10, Villejuif, France.,INSERM CESP U1018, Université Paris Saclay, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin-Bicêtre, France
| | - Antoine Cheret
- INSERM U1016, CNRS UMR8104, Institut Cochin, Paris, France.,AP-HP, Service de Médecine Interne et d'Immunologie Clinique, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Véronique Avettand-Fenoel
- Université de Paris, Faculté de Médecine, Paris, France.,INSERM U1016, CNRS UMR8104, Institut Cochin, Paris, France.,AP-HP, Laboratoire de Microbiologie clinique, Hôpital Necker-Enfants Malades, Paris, France
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Llibre JM, Cahn PE, Lo J, Barber TJ, Mussini C, van Welzen BJ, Hernandez B, Donovan C, Kisare M, Sithamparanathan M, van Wyk J. Changes in Inflammatory and Atherogenesis Biomarkers With the 2-Drug Regimen Dolutegravir Plus Lamivudine in Antiretroviral Therapy–Experienced, Virologically Suppressed People With HIV-1: A Systematic Literature Review. Open Forum Infect Dis 2022; 9:ofac068. [PMID: 35265729 PMCID: PMC8900931 DOI: 10.1093/ofid/ofac068] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 02/08/2022] [Indexed: 11/23/2022] Open
Abstract
Background The 2-drug regimen dolutegravir plus lamivudine has demonstrated long-term noninferior efficacy vs 3-/4-drug regimens (3/4DRs) in phase 3 trials. This systematic literature review summarizes clinical trial and real-world evidence evaluating impact of dolutegravir plus lamivudine on inflammatory and atherogenesis biomarkers in people with human immunodeficiency virus type 1 (PWH). Methods Using Ovid MEDLINE, Embase, PubMed, and Cochrane library databases and conference proceedings, we searched for studies published from 1 January 2013 to 14 July 2021, reporting changes in inflammatory and atherogenesis biomarkers with dolutegravir plus lamivudine in antiretroviral therapy–experienced, virologically suppressed PWH aged ≥18 years. Results Four records representing 2 randomized controlled trials (RCTs) and 6 records of real-world evidence met eligibility criteria. All real-world studies evaluated CD4+/CD8+ ratio, while only 1 assessed inflammatory biomarkers. Across both RCTs, no consistent pattern of change in biomarkers was observed between dolutegravir/lamivudine and 3/4DR comparators. There were significant changes in soluble CD14 favoring dolutegravir/lamivudine in TANGO at weeks 48 and 144 and SALSA at week 48, and in interleukin-6 favoring the control group in TANGO at weeks 48 and 144. In the real-world study evaluating inflammatory biomarkers, median soluble CD14 significantly decreased 48 weeks postswitch to dolutegravir plus lamivudine (P < .001), while other biomarkers remained stable. In all 6 real-world studies, increases in CD4+/CD8+ ratio were reported after switch to dolutegravir plus lamivudine (follow-up, 12–60 months). Conclusions Results show that dolutegravir plus lamivudine has a comparable impact on inflammatory and atherogenesis biomarkers vs 3/4DRs, with no consistent pattern of change after switch in virologically suppressed PWH.
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Affiliation(s)
- Josep M Llibre
- Infectious Diseases, Fundació Lluita contra la Sida, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | | | - Janet Lo
- Metabolism Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Tristan J Barber
- Ian Charleson Day Centre, Royal Free London NHS Foundation Trust, London, UK
- Institute for Global Health, University College London, London, UK
| | - Cristina Mussini
- Clinic of Infectious Diseases, AOU Policlinico, and University of Modena and Reggio Emilia, Modena, Italy
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Quantification of Total HIV DNA as a Marker to Measure Viral Reservoir: Methods and Potential Implications for Clinical Practice. Diagnostics (Basel) 2021; 12:diagnostics12010039. [PMID: 35054206 PMCID: PMC8774405 DOI: 10.3390/diagnostics12010039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/19/2021] [Accepted: 12/21/2021] [Indexed: 01/08/2023] Open
Abstract
The focus of this review is to examine the importance of quantifying total HIV DNA to target the HIV reservoir and the clinical implications and challenges involved in its future application in clinical practice. Despite intrinsic limitations, the quantification of total HIV DNA is currently the most widely used marker for exploring the HIV reservoir. As it allows estimating all forms of HIV DNA in the infected cells, total HIV DNA load is the biomarker of the HIV reservoir that provides most of the insights into HIV pathogenesis. The clinical role of total HIV-DNA in both untreated and treated patients is extensively supported by important lines of evidence. Thus, predictive models that include total HIV DNA load together with other variables could constitute a prognostic tool for use in clinical practice. To date, however, this marker has been primarily used in experimental evaluations. The main challenge is technical. Although the implementation of droplet digital PCR could improve analytical performance over real-time PCR, the lack of standardization has made cross-comparisons of the data difficult. An effort by investigators to compare protocols is needed. Furthermore, the main effort now should be to involve the biomedical industry in the development of certified assays for in vitro diagnostics use.
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Vassallo M, Durant J, Fabre R, Ticchioni M, Lotte L, Sindt A, Puchois A, De Monte A, Cezar R, Corbeau P, Pradier C. Switching to a Dual-Drug Regimen in HIV-Infected Patients Could Be Associated With Macrophage Activation? Front Med (Lausanne) 2021; 8:712880. [PMID: 34458287 PMCID: PMC8387698 DOI: 10.3389/fmed.2021.712880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 07/19/2021] [Indexed: 12/13/2022] Open
Abstract
Objectives: The aim of this study was to evaluate the effect on immune activation of switching from a triple-drug to a dual-drug regimen in HIV-1 infected patients on successful combination antiretroviral treatment (cART). Immunadapt is a prospective study evaluating the impact of cART simplification on immune activation. Methods: We prospectively collected blood samples in HIV-1 infected patients on stable and successful cART switching from triple to dual regimens as a simplifying strategy. We compared immune activation markers: high sensitivity CRP, IL-1, IL-6, IL-8, IP-10, MCP-1, TNF-alpha, soluble CD14 (sCD14), soluble CD163 (sCD163), lipopolysaccharide binding protein, and D-dimer before cART change and at least 6 months after the switch. Patients were stratified according to low or high risk factors of immune activation (low CD4 nadir, previous AIDS-defining condition or very-low-level viremia during follow-up). Results: From April 2019 to May 2020, 20 subjects were included (mean age 57 years, 25 years since HIV infection, CD4 666 cells/mm3, CD8 766 cells/mm3, CD4/CD8 0.94, CD4 nadir 326 cells/mm3, 15% with AIDS, 18 years on cART, 6 cART regimens received, current cART duration: 56 months). Fourteen patients were prescribed Dolutegravir + Rilpivirine and six received Dolutegravir + Lamivudine. After 6.9 months, a significant sCD163 increase (+ 25.5% vs. + 0.5%, p = 0.02) was observed in subjects with high risk factors, despite maintaining a viral load <50 cp/ml. Conclusion: cART simplification in favor of dual therapy is associated with macrophage activation in patients at risk of immune activation despite sustained virological control. Risk factors should thus be considered before generalizing such strategies.
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Affiliation(s)
- Matteo Vassallo
- Department of Internal Medicine/Infectious Diseases, Cannes General Hospital, Cannes, France.,Unité de Recherche Clinique Cote d'Azur (UR2CA), Centre Hospitalier Universitaire Pasteur 2, Nice, France
| | - Jacques Durant
- Infectious Diseases Department, Université Côte d'Azur, Nice, France
| | - Roxane Fabre
- Public Health Department, Nice University Hospital, Côte d'Azur University, Nice, France.,CoBTeK Lab, Nice University Hospital, Centre Memoire de Ressource et de Recherche, Côte d'Azur University, Nice, France
| | - Michel Ticchioni
- Laboratory of Immunology, Nice University Hospital, Université Côte d'Azur, Nice, France
| | - Laurene Lotte
- Multipurpose Laboratory, Cannes General Hospital, Cannes, France
| | - Audrey Sindt
- Multipurpose Laboratory, Cannes General Hospital, Cannes, France
| | - Annick Puchois
- Multipurpose Laboratory, Cannes General Hospital, Cannes, France
| | - Anne De Monte
- Laboratory of Virology, Nice University Hospital, Université Côte d'Azur, Nice, France
| | - Renaud Cezar
- Laboratory of Immunology, Nimes University Hospital, Nimes, France
| | - Pierre Corbeau
- Laboratory of Immunology, Nimes University Hospital, Nimes, France
| | - Christian Pradier
- Public Health Department, Nice University Hospital, Côte d'Azur University, Nice, France
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