Non-AIDS Events in Individuals With Spontaneous Control of HIV-1: A Systematic Review

Groenendijk, Albert L.; Vos, W. A.; Santos, Jéssica Cristina dos; Rokx, Casper; Ven, A.J.A.M. van der; Verbon, Annelies

doi:10.1097/qai.0000000000003066

Cited by 2 publications

(1 citation statement)

References 46 publications

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“…Despite ART, PLWH are at increased risk for nADEs, including non‐AIDS malignances, cardiovascular events, bacterial pneumonia and hepatic disease [33]. The risk of nADEs was significantly increased among patients with LLV, compared with no LLV patients [34].…”

Section: Llv: Definition and Clinical Implicationsmentioning

confidence: 99%

Clinical significance and management of low‐level HIV viremia in the era of integrase strand transfer inhibitors

Shi,

Ying,

Zheng

et al. 2023

HIV Medicine

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BackgroundPeople living with HIV (PLWH) and receiving antiretroviral therapy (ART) have a goal of achieving and maintaining viral suppression; however, the existence of PLWH that show events of low‐level viremia (LLV) between 50 and 1000 copies/mL and with different virological consequences have been observed. Moreover, some reports indicate that LLV status can lead to residual immune activation and inflammation, leading to a higher occurrence of non‐AIDS‐defining events (nADEs) and other adverse clinical outcomes. Until now, however, published data have shown controversial results that hinder understanding of this phenomenon's actual cause(s) and origin(s). Integrase strand transfer inhibitors (INSTIs)‐based therapies could lead to lower LLV over time and, therefore, more effective virological control.ObjectivesThis review aims to assess recent findings to provide a view of the clinical significance and management of low‐level HIV viremia in the era of INSTIs.

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Section: Llv: Definition and Clinical Implicationsmentioning

confidence: 99%

Clinical significance and management of low‐level HIV viremia in the era of integrase strand transfer inhibitors

Shi,

Ying,

Zheng

et al. 2023

HIV Medicine

View full text Add to dashboard Cite

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Risk of Non–AIDS–Defining Events Is Lower in Antiretroviral Therapy (ART)–Naive Human Immunodeficiency Virus Controllers Than in Normal Progressors on Suppressive ART

Groenendijk,

Miranda Afonso,

Wit

et al. 2024

Clinical Infectious Diseases

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Background We aimed to compare the non-AIDS events (nADE) risk between normal progressors using ART (NP-ART) and people with HIV (PWH) that naturally control HIV infection (HIV controllers), as well as the outcomes after ART in HIV controllers on nADE. Methods The primary endpoint was major nADE defined as the composite of cardiovascular disease, non-AIDS malignancy or all-cause mortality, whichever came first.. The role of ART in HIV controllers was assessed as a time-varying covariate. Results We included 1007 ART-naive HIV controllers (of which 60 elite controllers), 1510 Early-ART (<6 months after negative HIV test) and 15437 NP-ART (reference group), contributing 3813, 11,060 and 160,050 years of follow-up, respectively. HIV controllers had lower risk of the primary endpoint (HR 0.55, 95%CI 0.38-0.81, P = 0.0023), all-cause mortality (Adjusted Hazard ratio [aHR]: 0.45, 95% confidence interval [CI] 0.25-0.79, P = 0.0054), cardiovascular disease (aHR 0.47, 95%CI 0.22-0.99, P = 0.046) , but not non-AIDS malignancy (aHR 0.74, 95%CI 0.41-1.35, P = 0.33) than NP-ART. Among HIV controllers, each log10 lower baseline viral load further decreased the risk of nADE (aHR 0.54, 95% CI 0.29-0.99, P = 0.045). ART in HIV controllers did not reduce the risk of any nADE (aHR 1.22, 95% CI 0.66-2.29, P = 0.53). Conclusions We found a lower risk of nADE in HIV controllers than NP-ART, especially in those with low plasma viral loads. Initiation of ART did not alter the nADE risk in HIV controllers. Our findings help clinicians to decide on prescribing ART in HIV controllers.

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Non-AIDS Events in Individuals With Spontaneous Control of HIV-1: A Systematic Review

Abstract: Supplemental Digital Content is Available in the Text.

Cited by 2 publications

References 46 publications

Clinical significance and management of low‐level HIV viremia in the era of integrase strand transfer inhibitors

Clinical significance and management of low‐level HIV viremia in the era of integrase strand transfer inhibitors

Risk of Non–AIDS–Defining Events Is Lower in Antiretroviral Therapy (ART)–Naive Human Immunodeficiency Virus Controllers Than in Normal Progressors on Suppressive ART

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