Use of darunavir in HIV-1-infected individuals in routine clinical practice from 2012 to 2016 in France.
Journal
The Journal of antimicrobial chemotherapy
ISSN: 1460-2091
Titre abrégé: J Antimicrob Chemother
Pays: England
ID NLM: 7513617
Informations de publication
Date de publication:
01 11 2019
01 11 2019
Historique:
received:
04
02
2019
revised:
20
06
2019
accepted:
02
07
2019
pubmed:
7
8
2019
medline:
17
9
2020
entrez:
7
8
2019
Statut:
ppublish
Résumé
We assessed virological outcomes of darunavir use in France from 2012 to 2016, in three groups of people living with HIV (PLHIV): (i) antiretroviral (ARV)-naive PLHIV; (ii) ARV-experienced PLHIV switching to darunavir while failing therapy; and (iii) ARV-experienced PLHIV switching to darunavir while virologically controlled. Virological success (VS) was defined as a plasma HIV-1 viral load (VL) <50 copies/mL and virological failure (VF) as two consecutive VL >50 copies/mL or one VL >50 copies/mL followed by a treatment switch prior to the next VL measurement. The cumulative incidence of VS was assessed considering darunavir discontinuation, loss to follow-up and death as competing risks, while estimates of cumulative incidence of VF accounted for loss to follow-up and death. Among the 3235 ARV-naive PLHIV initiating darunavir, the 4 year cumulative incidence of VS was 80.9% and was associated with lower VL and higher CD4 cell counts. Among the 3485 ARV-experienced PLHIV switching to darunavir while failing therapy, the 4 year cumulative incidence of VS was 82.2% and was associated with lower VL. Among the 3005 ARV-experienced PLHIV switching to darunavir while virologically controlled, the 4 year cumulative incidence of VF was 12.6%. The risk of VF was higher with darunavir monotherapy [subdistribution hazard ratio (sHR)=1.67, 95% CI 1.15-2.42] while no difference was observed with dual therapy (sHR = 1.00, 95% CI 0.71-1.42) relative to triple therapy or more. Darunavir-containing regimens yielded similarly high rates of viral suppression in PLHIV whether they were ARV naive or ARV experienced switching to darunavir while failing therapy, or of maintaining VS in ARV-experienced PLHIV switching to darunavir while virologically controlled.
Identifiants
pubmed: 31384941
pii: 5543881
doi: 10.1093/jac/dkz338
doi:
Substances chimiques
HIV Protease Inhibitors
0
Darunavir
YO603Y8113
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
3305-3314Investigateurs
S Abgrall
(S)
L Bernard
(L)
E Billaud
(E)
F Boué
(F)
L Boyer
(L)
A Cabié
(A)
F Caby
(F)
A Canestri
(A)
D Costagliola
(D)
L Cotte
(L)
P De Truchis
(P)
X Duval
(X)
C Duvivier
(C)
P Enel
(P)
H Fischer
(H)
J Gasnault
(J)
C Gaud
(C)
S Grabar
(S)
C Katlama
(C)
M A Khuong
(MA)
O Launay
(O)
L Marchand
(L)
M Mary-Krause
(M)
S Matheron
(S)
G Melica-Grégoire
(G)
H Melliez
(H)
J L Meynard
(JL)
M Nacher
(M)
J Pavie
(J)
L Piroth
(L)
I Poizot-Martin
(I)
C Pradier
(C)
J Reynes
(J)
E Rouveix
(E)
A Simon
(A)
L Slama
(L)
P Tattevin
(P)
H Tissot-Dupont
(H)
G Astier
(G)
T Kurth
(T)
N Jacquemet
(N)
D Costagliola
(D)
S Abgrall
(S)
S Grabar
(S)
M Guiguet
(M)
S Leclercq
(S)
L Lièvre
(L)
M Mary-Krause
(M)
H Roul
(H)
H Selinger-Leneman
(H)
V Potard
(V)
Informations de copyright
© The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.