Forgiveness of Dolutegravir-Based Triple Therapy Compared With Older Antiretroviral Regimens: A Prospective Multicenter Cohort of Adherence Patterns and HIV-RNA Replication.

Details

Serval ID
serval:BIB_A796ED9B414A
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Forgiveness of Dolutegravir-Based Triple Therapy Compared With Older Antiretroviral Regimens: A Prospective Multicenter Cohort of Adherence Patterns and HIV-RNA Replication.
Journal
Open forum infectious diseases
Author(s)
Parienti J.J., Fournier A.L., Cotte L., Schneider M.P., Etienne M., Unal G., Perré P., Dutheil J.J., Morilland-Lecoq E., Chaillot F., Bangsberg D.R., Gagneux-Brunon A., Prazuck T., Cavassini M., Verdon R., Hocqueloux L.
ISSN
2328-8957 (Print)
ISSN-L
2328-8957
Publication state
Published
Issued date
07/2021
Peer-reviewed
Oui
Volume
8
Number
7
Pages
ofab316
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
For many people with HIV (PWH), taking antiretroviral therapy (ARV) every day is difficult.
Average adherence (Av-Adh) and log-transformed treatment interruption (TI) to ARV were prospectively measured over 6 months using electronic drug monitoring (EDM) in several cohorts of PWH. Multivariate linear regression models including baseline confounders explored the influence of EDM-defined adherence (R <sup>2</sup> ) on 6-month log <sub>10</sub> HIV-RNA. Multivariate logistic regression models were used to compare the risk of HIV-RNA detection (VR) within subgroups stratified by lower (≤95%) and higher (>95%) Av-Adh.
Three hundred ninety-nine PWH were analyzed with different ARVs: dolutegravir (n = 102), raltegravir (n = 90), boosted PI (bPI; n = 107), and NNRTI (n = 100). In the dolutegravir group, the influence of adherence pattern measures on R <sup>2</sup> for HIV-RNA levels was marginal (+2%). Av-Adh, TI, and Av-Adh × TI increased the R <sup>2</sup> for HIV-RNA levels by 54% and 40% in the raltegravir and bPI treatment groups, respectively. TI increased the R <sup>2</sup> for HIV-RNA levels by 36% in the NNRTI treatment group. Compared with the dolutegravir-based regimen, the risk of VR was significantly increased for raltegravir (adjusted odds ratio [aOR], 45.6; 95% CI, 4.5-462.1; P = .001), NNRTIs (aOR, 24.8; 95% CI, 2.7-228.4; P = .005), and bPIs (aOR, 28.3; 95% CI, 3.4-239.4; P = .002) in PWH with Av-Adh ≤95%. Among PWH with >95% Av-Adh, there were no significant differences in the risk of VR among the different ARVs.
These findings support the concept that dolutegravir in combination with 2 other active ARVs achieves greater virological suppression than older ARVs, including raltegravir, NNRTI, and bPI, among PWH with lower adherence.
Keywords
PWH, adherence, dolutegravir, missed doses
Pubmed
Web of science
Open Access
Yes
Create date
02/08/2021 14:53
Last modification date
22/07/2022 6:38
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