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Bremer B, Anastasiou OE, Hardtke S, Caruntu FA, Curescu MG, Yalcin K, Akarca US, Gürel S, Zeuzem S, Erhardt A, Lüth S, Papatheodoridis GV, Radu M, Idilman R, Manns MP, Cornberg M, Yurdaydin C, Wedemeyer H. Residual low HDV viraemia is associated HDV RNA relapse after PEG-IFNa-based antiviral treatment of hepatitis delta: Results from the HIDIT-II study. Liver Int 2021; 41:295-299. [PMID: 33217778 DOI: 10.1111/liv.14740] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 10/20/2020] [Accepted: 11/13/2020] [Indexed: 12/27/2022]
Abstract
The role of low levels of HDV-RNA during and after interferon therapy of hepatitis D is unknown. We re-analysed HDV RNA in 372 samples collected in the HIDIT-2 trial (Wedemeyer et al, Lancet Infectious Diseases 2019) with the Robogene assay (RA; Jena Analytics). Data were compared with the previously reported in-house assay (IA). We detected HDV-RNA in one-third of samples previously classified as undetectable using the highly sensitive RA. Low HDV viraemia detectable at week 48 or week 96 was associated with a high risk for post-treatment relapse, defined as HDV RNA positivity in both assays at week 120. HDV RNA relapses occurred in 10/15 (67%) patients with detectable low HDV RNA at week 48 and in 10/13 (77%) patients with low viraemia samples at week 96. In contrast, the post-treatment relapse rate was lower in patients with undetectable HDV RNA in both assays during treatment.
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Affiliation(s)
- Birgit Bremer
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Olympia E Anastasiou
- Institute for Virology, Essen University Hospital and Medical Faculty of the University of Duisburg-Essen, Essen, Germany
| | - Svenja Hardtke
- University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.,German Center for Infectious Disease Research (DZIF), HepNet Study-House, Hannover, Germany
| | | | | | - Kendal Yalcin
- Dicle University Medical Faculty, Diyarbakir, Turkey
| | | | - Selim Gürel
- Uludağ University Medical Faculty, Bursa, Turkey
| | - Stefan Zeuzem
- Johann Wolfgang Goethe University Medical Center, Frankfurt/Main, Germany
| | | | - Stefan Lüth
- Center of Internal Medicine II, University Hospital Brandenburg, Brandenburg Medical School, Brandenburg, Germany
| | | | - Monica Radu
- National Institute for Infectious Diseases Prof.Dr.Matei Bals, Bucharest, Romania
| | - Ramazan Idilman
- Department of Gastroenterology, Ankara University Medical School, Ankara, Turkey
| | - Michael P Manns
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.,German Center for Infectious Disease Research (DZIF), HepNet Study-House, Hannover, Germany
| | - Markus Cornberg
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.,German Center for Infectious Disease Research (DZIF), HepNet Study-House, Hannover, Germany
| | - Cihan Yurdaydin
- Department of Gastroenterology, Ankara University Medical School, Ankara, Turkey.,Department of Gastroenterology and Hepatology, Koç University Medical School, Istanbul, Turkey
| | - Heiner Wedemeyer
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.,German Center for Infectious Disease Research (DZIF), HepNet Study-House, Hannover, Germany.,Department of Gastroenterology and Hepatology, Essen University Hospital and Medical Faculty of the University of Duisburg-Essen, Essen, Germany
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Teira R, Vidal F, Muñoz-Sánchez P, Geijo P, Viciana P, Ribera E, Domingo P, Castaño M, Martínez E, Roca B, Puig T, Estrada V, Deig E, Galindo MJ, de la Fuente B, Lozano F, Montero M, Muñoz-Sanz A, Sanchez T, Terrón A, Romero-Palacios A, Lacalle JR, Garrido M, Suárez-Lozano I. Very low level viraemia and risk of virological failure in treated HIV-1-infected patients. HIV Med 2016; 18:196-203. [PMID: 27476742 DOI: 10.1111/hiv.12413] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of the study was to investigate whether very low level viraemia (VLLV) (20-50 HIV-1 RNA copies/mL) was associated with increased risk of virological failure (VF) as compared with persistent full suppression (< 20 copies/mL). METHODS From the VACH Cohort database, we selected those patients who started antiretroviral therapy (ART) after January 1997 and who achieved effective viral suppression [two consecutive viral loads (VLs) < 50 copies/mL] followed by full suppression (at least one VL <20 copies/mL). We carried out survival analyses to investigate whether the occurrence of VLLV rather than maintaining full suppression at < 20 copies/mL was associated with virological failure (two consecutive VLs > 200 copies/mL or one VL > 200 copies/mL followed by a change of ART regimen, administrative censoring or loss to follow-up), adjusted for nadir CD4 cell count, sex, age, ethnicity, transmission group, type of ART and time on effective suppression at < 50 copies/mL. RESULTS Of 21 480 patients who started ART, 13 674 (63.7%) achieved effective suppression at < 50 copies/mL, of whom 4289 (31.4%) further achieved full suppression at < 20 copies/mL after May 2009. A total of 2623 patients (61.1%) remained fully suppressed thereafter, while 1666 had one or more episodes of VL detection > 20 copies/mL (excluding virological failure). A total of 824 patients had VLLV after suppression at < 20 copies/mL. VLLV was not associated with virological failure as compared with persistent full suppression [hazard ratio (HR) 0.67; 95% confidence interval (CI) 0.44-1.00], independently of the number of blips recorded (from one to 18). CONCLUSIONS In our population of HIV-infected patients on ART who achieved viral suppression at < 20 copies/mL, the risk of virological failure was no different for patients who remained fully suppressed compared with those who experienced subsequent episodes of VLLV.
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Affiliation(s)
- R Teira
- Sierrallana Hospital, Torrelavega, Spain
| | - F Vidal
- Tarragona University Hospital Joan XXIII, Tarragona, Spain
| | | | - P Geijo
- Virgen de la Luz Hospital, Cuenca, Spain
| | - P Viciana
- Virgen del Rocío Hospital, Sevilla, Spain
| | - E Ribera
- Vall d'Hebrón Hospital, Barcelona, Spain
| | - P Domingo
- Santa Creu i Sant Pau Hospital, Barcelona, Spain
| | | | | | - B Roca
- General Hospital, Castellón, Spain
| | - T Puig
- Arnau de Vilanova Hospital, Lleida, Spain
| | - V Estrada
- San Carlos Clinical Hospital, Madrid, Spain
| | - E Deig
- General Hospital, Granollers, Spain
| | | | | | | | | | | | - T Sanchez
- Virgen de Rosell Hospital, Cartagena, Spain
| | - A Terrón
- SAS Hospital, Jérez de la Frontera, Spain
| | | | | | - M Garrido
- VACH Medical Association, Cartaya, Spain
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McKinnon E, Castley A, Payne L, Pummer S, Nolan D. Determinants of residual viraemia during combination HIV treatment: Impacts of baseline HIV RNA levels and treatment choice. HIV Med 2015; 17:495-504. [PMID: 26537660 DOI: 10.1111/hiv.12323] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2015] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Effective HIV therapy reflects suppression of plasma HIV RNA levels below assay detection thresholds, although lower levels of "residual viraemia" have also been demonstrated over extended periods of effective antiretroviral treatment. Here we examine the determinants of HIV RNA suppression below the standard assay threshold (40 HIV-1 RNA copies/mL) as well as factors associated with detectable HIV RNA below this reported detection limit. METHODS Between 2007 and 2010, 11 575 consecutive viral load (VL) tests were obtained from 1540 patients, including 356 on effective antiretroviral therapy followed since initiation (1996-2001: n = 165; 2002-2009: n = 191). Analyses modelled the probability of an undetectable VL given successful suppression to < 200 copies/mL, and the probability of residual viraemia given an undetectable result. RESULTS Detectable HIV RNA amplification was demonstrated in 20% of samples with a VL result < 40 copies/mL. Longitudinal analyses from 356 patients revealed that the likelihood of achieving results < 40 copies/mL was increased with current nonnucleoside reverse transcriptase inhibitor (NNRTI) therapy [odds ratio (OR) 2.0; P < 0.05] and reduced with prior virological rebound (OR 0.5; P < 0.05). In contrast, the presence of detectable HIV RNA < 40 copies/mL was strongly associated with pretreatment HIV RNA levels among those on current protease inhibitor (PI) treatment (OR 1.5 per log10 copies/mL increase; P = 0.02) as well as those on NNRTIs (OR 1.7; P = 0.002). CONCLUSIONS While HIV treatment history was associated with plasma HIV RNA levels below the detection limit, residual viraemia results were dominantly determined by pretreatment VL. These findings support the concept of a stable, long-lived reservoir of latently infected cells as a source of residual viraemia despite effective HIV treatment.
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Affiliation(s)
- E McKinnon
- Institute for Immunology and Infectious Diseases, Murdoch University, Perth, WA, Australia
| | - A Castley
- PathWest Laboratory Medicine, Department of Clinical Immunology, Royal Perth Hospital, Perth, WA, Australia.,School of Veterinary and Life Sciences, Murdoch University, Perth, WA, Australia
| | - L Payne
- PathWest Laboratory Medicine, Department of Clinical Immunology, Royal Perth Hospital, Perth, WA, Australia
| | - S Pummer
- PathWest Laboratory Medicine, Department of Clinical Immunology, Royal Perth Hospital, Perth, WA, Australia
| | - D Nolan
- Institute for Immunology and Infectious Diseases, Murdoch University, Perth, WA, Australia.,PathWest Laboratory Medicine, Department of Clinical Immunology, Royal Perth Hospital, Perth, WA, Australia
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Gianotti N, Canducci F, Galli L, Cossarini F, Salpietro S, Poli A, Nozza S, Spagnuolo V, Clementi M, Sampaolo M, Ceresola ER, Racca S, Lazzarin A, Castagna A. HIV DNA loads, plasma residual viraemia and risk of virological rebound in heavily treated, virologically suppressed HIV-infected patients. Clin Microbiol Infect 2014; 21:103.e7-103.e10. [PMID: 25636935 DOI: 10.1016/j.cmi.2014.08.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 07/29/2014] [Accepted: 08/02/2014] [Indexed: 01/19/2023]
Abstract
In this single-centre, retrospective study, we analyzed data of 194 patients receiving antiretroviral therapy with <50 human immunodeficiency virus (HIV) RNA copies/mL in plasma and 318 HIV RNA/DNA paired samples. By kinetic polymerase chain reaction (kPCR) molecular system analysis, 104 (54%) subjects had undetectable HIV RNA and 90 (46%) had residual viraemia. Median (interquartile range) HIV DNA load was 780 (380-1930) copies/10(6) peripheral blood lymphocytes (PBL), and HIV DNA loads were independently associated with residual viraemia (p 0.002). Virological rebound occurred in 29/194 (15%) patients over a median (interquartile range) follow-up of 17.5 (13.5-31.5) months. Residual viraemia (p 0.002), but not HIV DNA load, was independently associated with virological rebound.
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Affiliation(s)
- N Gianotti
- Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy.
| | - F Canducci
- Microbiology and Virology, San Raffaele Scientific Institute, Milan, Italy; Dipartimento di Biotecnologie e Scienze della Vita, University of Insubria, Varese, Italy
| | - L Galli
- Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy
| | - F Cossarini
- Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy
| | - S Salpietro
- Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy
| | - A Poli
- Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy
| | - S Nozza
- Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy
| | - V Spagnuolo
- Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy
| | - M Clementi
- Microbiology and Virology, San Raffaele Scientific Institute, Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy
| | - M Sampaolo
- Microbiology and Virology, San Raffaele Scientific Institute, Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy
| | - E R Ceresola
- Microbiology and Virology, San Raffaele Scientific Institute, Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy
| | - S Racca
- Microbiology and Virology, San Raffaele Scientific Institute, Milan, Italy
| | - A Lazzarin
- Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy
| | - A Castagna
- Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy
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Charpentier C, Choquet M, Joly V, Yeni P, Visseaux B, Caseris M, Brun-Vézinet F, Yazdanpanah Y, Peytavin G, Descamps D, Landman R. Virological outcome at week 48 of three recommended first-line regimens using ultrasensitive viral load and plasma drug assay. J Antimicrob Chemother 2014; 69:2819-25. [PMID: 24948705 DOI: 10.1093/jac/dku211] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To describe the virological and pharmacological outcomes of three different recommended once-daily first-line regimens in a cross-sectional analysis within an observational cohort using ultra-sensitive HIV quantification. PATIENTS AND METHODS We enrolled all HIV-1-infected patients who initiated tenofovir/emtricitabine with efavirenz, darunavir/ritonavir or atazanavir/ritonavir as a first-line regimen between 1 November 2010 and 30 June 2012. An ultrasensitive viral load (VL) assay was performed and plasma drug concentrations at 24 h (C24) were determined at Week (W) 4, W12, W24, W36 and W48. RESULTS Sixty patients initiated efavirenz, 81 darunavir/ritonavir and 27 atazanavir/ritonavir. A higher proportion of patients with a VL >100 000 copies/mL received darunavir/ritonavir (P = 0.022). At W48, 89%, 85% and 88% of the patients had a VL <50 copies/mL, 69%, 73% and 79% had a VL <20 copies/mL and 45%, 48% and 54% had a VL <1 copy/mL using the ultrasensitive assay in the efavirenz, darunavir/ritonavir and atazanavir/ritonavir groups, respectively. Patients with a detectable VL signal at W48 had a higher baseline VL than those with no detectable VL signal (P = 0.0001). A total of 92%, 93% and 91% of the efavirenz, darunavir and atazanavir C24 values were above the respective effective cut-offs. CONCLUSIONS In this observational cohort, the choice of the regimen was related to the physicians' preferences and the patients' characteristics. The proportion of patients reaching VL <1 copy/mL at W48 was similar in the three regimens and was not associated with drug concentrations.
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Affiliation(s)
- Charlotte Charpentier
- IAME, UMR 1137, Univ Paris Diderot, Sorbonne Paris Cité, F-75018 Paris, France IAME, UMR 1137, INSERM, F-75018 Paris, France AP-HP, Hôpital Bichat-Claude Bernard, Laboratoire de Virologie, F-75018 Paris, France
| | - Marion Choquet
- AP-HP, Hôpital Bichat-Claude Bernard, Laboratoire de Pharmacologie, F-75018 Paris, France
| | - Véronique Joly
- IAME, UMR 1137, Univ Paris Diderot, Sorbonne Paris Cité, F-75018 Paris, France IAME, UMR 1137, INSERM, F-75018 Paris, France AP-HP, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales, F-75018 Paris, France
| | - Patrick Yeni
- IAME, UMR 1137, Univ Paris Diderot, Sorbonne Paris Cité, F-75018 Paris, France IAME, UMR 1137, INSERM, F-75018 Paris, France AP-HP, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales, F-75018 Paris, France
| | - Benoit Visseaux
- IAME, UMR 1137, Univ Paris Diderot, Sorbonne Paris Cité, F-75018 Paris, France IAME, UMR 1137, INSERM, F-75018 Paris, France AP-HP, Hôpital Bichat-Claude Bernard, Laboratoire de Virologie, F-75018 Paris, France
| | - Marion Caseris
- AP-HP, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales, F-75018 Paris, France
| | | | - Yazdan Yazdanpanah
- IAME, UMR 1137, Univ Paris Diderot, Sorbonne Paris Cité, F-75018 Paris, France IAME, UMR 1137, INSERM, F-75018 Paris, France AP-HP, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales, F-75018 Paris, France
| | - Gilles Peytavin
- IAME, UMR 1137, Univ Paris Diderot, Sorbonne Paris Cité, F-75018 Paris, France IAME, UMR 1137, INSERM, F-75018 Paris, France AP-HP, Hôpital Bichat-Claude Bernard, Laboratoire de Pharmacologie, F-75018 Paris, France
| | - Diane Descamps
- IAME, UMR 1137, Univ Paris Diderot, Sorbonne Paris Cité, F-75018 Paris, France IAME, UMR 1137, INSERM, F-75018 Paris, France AP-HP, Hôpital Bichat-Claude Bernard, Laboratoire de Virologie, F-75018 Paris, France
| | - Roland Landman
- IAME, UMR 1137, Univ Paris Diderot, Sorbonne Paris Cité, F-75018 Paris, France IAME, UMR 1137, INSERM, F-75018 Paris, France AP-HP, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales, F-75018 Paris, France
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