Titre
Determinants of sustained viral suppression in HIV-infected patients with self-reported poor adherence to antiretroviral therapy.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Glass, T.R.
Auteure/Auteur
Rotger, M.
Auteure/Auteur
Telenti, A.
Auteure/Auteur
Decosterd, L.
Auteure/Auteur
Csajka, C.
Auteure/Auteur
Bucher, H.C.
Auteure/Auteur
Günthard, H.F.
Auteure/Auteur
Rickenbach, M.
Auteure/Auteur
Nicca, D.
Auteure/Auteur
Hirschel, B.
Auteure/Auteur
Bernasconi, E.
Auteure/Auteur
Wandeler, G.
Auteure/Auteur
Battegay, M.
Auteure/Auteur
Marzolini, C.
Auteure/Auteur
Contributrices/contributeurs
Barth, J.
Battegay, M.
Bernasconi, E.
Böni, J.
Bucher, HC.
Burton-Jeangros, C.
Calmy, A.
Cavassini, M.
Cellerai, C.
Egger, M.
Elzi, L.
Fehr, J.
Fellay, J.
Flepp, M.
Francioli, P.
Furrer, H.
Fux, C.
Gorgievski, M.
Günthard, H.
Haerry, D.
Hasse, B.
Hirsch, HH.
Hirschel, B.
Hösli, I.
Kahlert, Ch.
Kaiser, L.
Keiser, O.
Kind, C.
Klimkait, T.
Kovari, H.
Ledergerber, B.
Martinetti, G.
Martinez, B.
Metzner, K.
Müller, N.
Nadal, D.
Pantaleo, G.
Rauch, A.
Regenass, S.
Rickenbach, M.
Rudin, C.
Schmid, P.
Schultze, D.
Schöni-Affolter, F.
Schüpbach, J.
Speck, R.
Taffé, P.
Tarr, P.
Telenti, A.
Trkola, A.
Vernazza, P.
Weber, R.
Yerly, S.
Groupes de travail
Swiss HIV Cohort Study
Liens vers les personnes
Liens vers les unités
ISSN
1932-6203
Statut éditorial
Publié
Date de publication
2012-01
Volume
7
Numéro
1
Première page
e29186
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Résumé
BACKGROUND: Good adherence to antiretroviral therapy (ART) is critical for successful HIV treatment. However, some patients remain virologically suppressed despite suboptimal adherence. We hypothesized that this could result from host genetic factors influencing drug levels.
METHODS: Eligible individuals were Caucasians treated with efavirenz (EFV) and/or boosted lopinavir (LPV/r) with self-reported poor adherence, defined as missing doses of ART at least weekly for more than 6 months. Participants were genotyped for single nucleotide polymorphisms (SNPs) in candidate genes previously reported to decrease EFV (rs3745274, rs35303484, rs35979566 in CYP2B6) and LPV/r clearance (rs4149056 in SLCO1B1, rs6945984 in CYP3A, rs717620 in ABCC2). Viral suppression was defined as having HIV-1 RNA <400 copies/ml throughout the study period.
RESULTS: From January 2003 until May 2009, 37 individuals on EFV (28 suppressed and 9 not suppressed) and 69 on LPV/r (38 suppressed and 31 not suppressed) were eligible. The poor adherence period was a median of 32 weeks with 18.9% of EFV and 20.3% of LPV/r patients reporting missed doses on a daily basis. The tested SNPs were not determinant for viral suppression. Reporting missing >1 dose/week was associated with a lower probability of viral suppression compared to missing 1 dose/week (EFV: odds ratio (OR) 0.11, 95% confidence interval (CI): 0.01-0.99; LPV/r: OR 0.29, 95% CI: 0.09-0.94). In both groups, the probability of remaining suppressed increased with the duration of continuous suppression prior to the poor adherence period (EFV: OR 3.40, 95% CI: 0.62-18.75; LPV/r: OR 5.65, 95% CI: 1.82-17.56).
CONCLUSIONS: The investigated genetic variants did not play a significant role in the sustained viral suppression of individuals with suboptimal adherence. Risk of failure decreased with longer duration of viral suppression in this population.
METHODS: Eligible individuals were Caucasians treated with efavirenz (EFV) and/or boosted lopinavir (LPV/r) with self-reported poor adherence, defined as missing doses of ART at least weekly for more than 6 months. Participants were genotyped for single nucleotide polymorphisms (SNPs) in candidate genes previously reported to decrease EFV (rs3745274, rs35303484, rs35979566 in CYP2B6) and LPV/r clearance (rs4149056 in SLCO1B1, rs6945984 in CYP3A, rs717620 in ABCC2). Viral suppression was defined as having HIV-1 RNA <400 copies/ml throughout the study period.
RESULTS: From January 2003 until May 2009, 37 individuals on EFV (28 suppressed and 9 not suppressed) and 69 on LPV/r (38 suppressed and 31 not suppressed) were eligible. The poor adherence period was a median of 32 weeks with 18.9% of EFV and 20.3% of LPV/r patients reporting missed doses on a daily basis. The tested SNPs were not determinant for viral suppression. Reporting missing >1 dose/week was associated with a lower probability of viral suppression compared to missing 1 dose/week (EFV: odds ratio (OR) 0.11, 95% confidence interval (CI): 0.01-0.99; LPV/r: OR 0.29, 95% CI: 0.09-0.94). In both groups, the probability of remaining suppressed increased with the duration of continuous suppression prior to the poor adherence period (EFV: OR 3.40, 95% CI: 0.62-18.75; LPV/r: OR 5.65, 95% CI: 1.82-17.56).
CONCLUSIONS: The investigated genetic variants did not play a significant role in the sustained viral suppression of individuals with suboptimal adherence. Risk of failure decreased with longer duration of viral suppression in this population.
PID Serval
serval:BIB_5217BD6F9449
PMID
Open Access
Oui
Date de création
2013-01-17T15:16:46.656Z
Date de création dans IRIS
2025-05-20T18:53:12Z
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Nom
BIB_5217BD6F9449.P001.pdf
Version du manuscrit
published
Licence
https://creativecommons.org/licenses/by/4.0
Taille
264.13 KB
Format
Adobe PDF
PID Serval
serval:BIB_5217BD6F9449.P001
URN
urn:nbn:ch:serval-BIB_5217BD6F94493
Somme de contrôle
(MD5):bdc7aedbc18bf85047304c0a41c95577