Higher efficacy of nevirapine than efavirenz to achieve HIV-1 plasma viral load below 1 copy/ml

Haïm-Boukobza, Stéphanie; Morand‐Joubert, Laurence; Flandre, Philippe; Valin, Nadia; Fourati, Slim; Sayon, Sophie; Lavignon, Marc; Simon, Anne; Girard, Pierre‐Marie; Katlama, Christine; Cálvez, Vincent; Marcelin, Anne–Geneviève

doi:10.1097/qad.0b013e3283427de3

Cited by 45 publications

(33 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…More potent effects on residual viremia have been demonstrated with the use of NNRTIs than with protease inhibitors (5,21), and a better performance of nevirapine than efavirenz has been suggested (5,13). In this study, no significant association was demonstrated between HAART composition and undetectable levels of HIV DNA.…”

Section: Discussionmentioning

confidence: 37%

Baseline Cellular HIV DNA Load Predicts HIV DNA Decline and Residual HIV Plasma Levels during Effective Antiretroviral Therapy

et al. 2012

View full text Add to dashboard Cite

Cellular human immunodeficiency virus type 1 (HIV-1) DNA may be considered a marker of disease progression with significant predictive power, but published data on its correlation with plasma HIV RNA levels and CD4 counts in acute and chronic patients are not conclusive. We evaluated a cohort of 180 patients naïve for antiretroviral therapy before the beginning of treatment and after a virological response in order to define the indicators correlated with HIV DNA load decrease until undetectability. The following variables were evaluated as continuous variables: age, CD4 cell count and log 10 HIV DNA level at baseline and follow-up, and baseline log 10 HIV RNA level. Primary HIV infection at the start of therapy, an HIV RNA level at follow-up of <2.5 copies/ml, origin, gender, and transmission risk were evaluated as binary variables. The decline of HIV DNA values during effective therapy was directly related to baseline HIV DNA and HIV RNA values, to an increase in the number of CD4 cells, and to the achievement of an HIV RNA load of <2.5 copies/ml. An undetectable cellular HIV DNA load was achieved by 21.6% of patients at the follow-up time point and correlated significantly with lower baseline cellular HIV DNA values and with being in the primary stage of infection when therapy started. In conclusion, early treatment facilitated the achievement of undetectable levels of plasma viremia and cellular HIV DNA and a better recovery of CD4 lymphocytes. HIV DNA levels before and during highly active antiretroviral therapy may be used as a new tool for monitoring treatment efficacy.

show abstract

Section: Discussionmentioning

confidence: 37%

Baseline Cellular HIV DNA Load Predicts HIV DNA Decline and Residual HIV Plasma Levels during Effective Antiretroviral Therapy

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Intensification studies of conventional HAART to determine the contribution of ongoing viral replication to residual viremia have shown heterogeneous results: while Yukl et al found a decrease of unspliced HIV RNA in the ileum (but not in plasma, PBMCs, duodenum, colon, or rectum), 36 other authors found no effect. [37][38][39][40][41][42][43][44][45][46] It is noteworthy that none of these studies included the use of nevirapine: the drug has been associated with the lowest residual viremia in two studies 8,9 and with long-term control of HIV viremia in a dual therapy with raltegravir. 47 Despite some unfavorable characteristics (hepatotoxicity, skin rashes, low genetic barrier to resistance) that placed nevirapine among alternative regimens in international guidelines, favorable pharmacokinetic features and tolerability may support prospective switch studies using nevirapine-containing regimens.…”

Section: Discussionmentioning

confidence: 95%

“…3 Although the exact source of residual HIV RNA is still debated, 4 it has been associated with possible indicators of viral reservoirs size (T lymphocyte CD4 + cell count at nadir, pretreatment HIV-1 RNA, and quantitative cell-associated HIV proviral DNA) and with the duration of viral suppression on HAART. [5][6][7] Several studies suggested that the administration of nonnucleoside reverse transcriptase inhibitors (NNRTIs) (and specifically nevirapine) is associated with the lowest residual viremia 8,9 : the drug target (preintegration) or the penetration into sanctuary sites has been advocated as a possible explanation of this observation. 10 Although the exact impact of vLLV in the long-term management of HIV is poorly understood, two aspects have been studied.…”

Section: Introductionmentioning

confidence: 99%

HIV-1 Very Low Level Viremia Is Associated with Virological Failure in Highly Active Antiretroviral Treatment-Treated Patients

Calcagno

Motta

Ghisetti

et al. 2015

AIDS Research and Human Retroviruses

View full text Add to dashboard Cite

The aim of this study was to evaluate the impact of HIV-1 very low-level viremia (<50 copies/ml) on the 2-year risk of virological failure. A retrospective analysis including HIV-positive patients presenting two consecutive HIV RNA below 50 copies/ml (outpatient clinic in Italy, first semester of 2010) was performed. HIV RNA was measured through real time polymerase chain reaction (PCR) assay CAP/CTM HIV-1 version 2.0 (detection limit: 20 copies/ml) and stratified as undetectable RNA ("Target Not Detected", TND), <20 copies/ml, 20-50 copies/ml. After 96 weeks virological failure was defined as two consecutive viral loads above 50 copies/ml. Log-rank tests and a multivariate Cox proportional hazard model were used for univariate and multivariate analysis. A total of 1,055 patients (71.4% male, 87.4% white, aged 46.7 years) were included: nadir and current CD4 cell counts were 203 cells/mm(3) (106-292) and 554 cells/mm(3) (413-713.5). HIV RNA was undetectable in 781 patients (74%), <20 copies/ml in 190 patients (18%) and 20-50 copies/ml in 84 patients (8%). Virological failure was observed in 81 patients (7.7%); at multivariate analysis detectable RNA at baseline (p=0.017), HCV infection (p=0.020), more than three pills in the regimen (p=0.003), and duration of HIV RNA <50 copies/ml below 2 years (p<0.001) were independently associated with virological failure. In 14 patients newly selected resistance-associated mutations were observed. Undetectable HIV RNA by real-time PCR is significantly associated with a lower 2-year risk of virological failure along with Ab HCV negativity, longer viral control, and lower pill burden. Studies investigating the management of residual viremia under antiretroviral treatment are warranted.

show abstract

“…Except for screening samples assessed locally, total cell HIV DNA was quantified in PBMCs and rectal tissue by ultrasensitive real-time PCR as previously described [20][21][22] at the Pitié-Salpétrière virology laboratory. Ultrasensitive plasma HIV-1 RNA was measured at screening, baseline (D0), weeks 8, 12,28, 36 and 56 with a limit of quantification of 1 copy/ml, as previously reported [23].…”

Section: Treatment Interventionsmentioning

confidence: 99%

Treatment intensification followed by interleukin-7 reactivates HIV without reducing total HIV DNA

Katlama

Lambert-Niclot

Assoumou

et al. 2016

Aids

Self Cite

View full text Add to dashboard Cite

show abstract

Higher efficacy of nevirapine than efavirenz to achieve HIV-1 plasma viral load below 1 copy/ml

Cited by 45 publications

References 11 publications

Baseline Cellular HIV DNA Load Predicts HIV DNA Decline and Residual HIV Plasma Levels during Effective Antiretroviral Therapy

Baseline Cellular HIV DNA Load Predicts HIV DNA Decline and Residual HIV Plasma Levels during Effective Antiretroviral Therapy

HIV-1 Very Low Level Viremia Is Associated with Virological Failure in Highly Active Antiretroviral Treatment-Treated Patients

Treatment intensification followed by interleukin-7 reactivates HIV without reducing total HIV DNA

Contact Info

Product

Resources

About