Long-term virological effectiveness with darunavir/ritonavir-based salvage therapy in people living with HIV/AIDS from São Paulo, Brazil.
Ariane Melaré Ramos Dos SantosAmaury Pachione MartinsDenise JuliatoÉrique José Farias Peixoto de MirandaGiselle Ibette Silva Lopez LopesLuís Fernando de Macedo BrígidoJosé Ernesto VidalPublished in: International journal of STD & AIDS (2020)
Even though darunavir/ritonavir (DRV/r) has high potency and a greater genetic barrier, there are few studies on the long-term effectiveness of DRV/r-based salvage therapy in people living with HIV (PLWH) in low and middle-income countries. This retrospective cohort study, from São Paulo, Brazil, included ART-experienced PLWH aged ≥18 years with virological failure (VF) who had started DRV/r plus an optimized background regimen (OBR) between 2008 and 2012. The proportion of patients with viral load (VL) <50 copies/mL, the improved mean CD4+ T cell count and the factors associated with VF during the 144-week follow-up were assessed. The study included 173 patients with the following characteristics [median (interquartile range)]: age 48 (42 -53) years; CD4+ T cell count, 229 (89 -376) cells/mm3; VL, 4.26 (3.70 -4.74) log10; 6 (4 -7) previous regimens; and 100 (38 -156) months of VF. After 144 weeks, 129 (75%) patients had VL< 50 copies/mL and a mean increase in the CD4+ T cell count of 190 cells/mm3. VL>100,000 copies/mL and poor adherence were associated with VF. DRV/r plus an OBR showed high long-term virological suppression and immunological recovery. VL>100,000 copies/mL and poor adherence were associated with VF at 144 weeks.
Keyphrases
- antiretroviral therapy
- hiv aids
- hiv infected patients
- hiv infected
- induced apoptosis
- human immunodeficiency virus
- cell cycle arrest
- randomized controlled trial
- systematic review
- end stage renal disease
- ejection fraction
- peripheral blood
- endoplasmic reticulum stress
- clinical trial
- peritoneal dialysis
- oxidative stress
- stem cells
- cell death
- cell proliferation
- patient reported outcomes
- insulin resistance
- smoking cessation
- replacement therapy
- study protocol