HIV-1 genital shedding in HIV-infected patients randomized to second-line lopinavir/ritonavir monotherapy versus tenofovir/lamivudine/lopinavir/ritonavir
HIV-1 shedding in genital secretions is associated with HIV transmission risk. Limited data exist on the effect of second-line lopinavir/ritonavir monotherapy (mLPV/r) on genital secretion of HIV RNA. We measured HIV-1 in genital secretions of HIV-infected adults at time of failure from non-nucleosi...
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| Veröffentlicht in: | Antiviral therapy 2014-01, Vol.19 (6), p.579-586 |
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| creator | Bunupuradah, Torsak Bowonwattanuwong, Chureeratana Jirajariyavej, Supunnee Munsakul, Warangkana Klinbuayaem, Virat Sophonphan, Jiratchaya Mahanontharit, Apicha Hirschel, Bernard Ruxrungtham, Kiat Ananworanich, Jintanat |
| description | HIV-1 shedding in genital secretions is associated with HIV transmission risk. Limited data exist on the effect of second-line lopinavir/ritonavir monotherapy (mLPV/r) on genital secretion of HIV RNA.
We measured HIV-1 in genital secretions of HIV-infected adults at time of failure from non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimens and at 48 weeks after being randomized to second-line mLPV/r versus tenofovir/lamivudine/LPV/r (TDF/3TC/LPV/r). Plasma and genital secretion (semen, vaginal swab) HIV RNA was quantified by the CobasAmpliprep/TaqMan assay.
Forty enrolled (15 on mLPV/r and 25 on TDF/3TC/LPV/r). Median age was 37.8 years and 35% were male. Median baseline CD4(+) T-cell count was 222 cells/mm(3), plasma HIV RNA was 4.1 log10 copies/ml and genital secretion HIV RNA was 2.3 log10 copies/ml. At week 48, the proportion of patients with plasma HIV RNA50 copies/ml at week 48 was baseline genital secretion HIV RNA>50 copies/ml (P=0.049).
LPV/r either given alone or in combination with TDF/3TC as second-line treatment achieved high genital secretion HIV RNA suppression rate. Genital secretion HIV RNA remained detectable at low levels in one-third of patients with suppressed plasma viraemia. |
| doi_str_mv | 10.3851/IMP2737 |
| format | Article |
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We measured HIV-1 in genital secretions of HIV-infected adults at time of failure from non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimens and at 48 weeks after being randomized to second-line mLPV/r versus tenofovir/lamivudine/LPV/r (TDF/3TC/LPV/r). Plasma and genital secretion (semen, vaginal swab) HIV RNA was quantified by the CobasAmpliprep/TaqMan assay.
Forty enrolled (15 on mLPV/r and 25 on TDF/3TC/LPV/r). Median age was 37.8 years and 35% were male. Median baseline CD4(+) T-cell count was 222 cells/mm(3), plasma HIV RNA was 4.1 log10 copies/ml and genital secretion HIV RNA was 2.3 log10 copies/ml. At week 48, the proportion of patients with plasma HIV RNA<50 copies/ml was 13/15 (87%) in mLPV/r and 21/25 (84%) in TDF/3TC/LPV/r arms. Median genital HIV RNA was significantly decreased from baseline in both arms (P=0.009 in mLPV/r and P=0.001 in TDF/3TC/LPV/r). In subjects with suppressed plasma HIV RNA, 12/34 (35%; 6/13 [46%] in the mLPV/r and 6/21 [29%] in the TDF/3TC/LPV/r arms) had detectable HIV RNA (range 74-957 copies/ml) in the genital secretions (P=0.41). By multivariate analysis, the only predictor of having genital HIV RNA>50 copies/ml at week 48 was baseline genital secretion HIV RNA>50 copies/ml (P=0.049).
LPV/r either given alone or in combination with TDF/3TC as second-line treatment achieved high genital secretion HIV RNA suppression rate. Genital secretion HIV RNA remained detectable at low levels in one-third of patients with suppressed plasma viraemia.</description><identifier>ISSN: 1359-6535</identifier><identifier>EISSN: 2040-2058</identifier><identifier>DOI: 10.3851/IMP2737</identifier><identifier>PMID: 24464590</identifier><language>eng</language><publisher>England</publisher><subject>Adenine - analogs & derivatives ; Adult ; Anti-HIV Agents - pharmacology ; Anti-HIV Agents - therapeutic use ; Antiretroviral Therapy, Highly Active ; Female ; Follow-Up Studies ; Genitalia - virology ; HIV Infections - drug therapy ; HIV Infections - virology ; HIV-1 - drug effects ; HIV-1 - physiology ; Human immunodeficiency virus ; Human immunodeficiency virus 1 ; Humans ; Lamivudine ; Lopinavir ; Male ; Organophosphonates ; Risk Factors ; Ritonavir ; Tenofovir ; Time Factors ; Treatment Outcome ; Viral Load ; Virus Shedding</subject><ispartof>Antiviral therapy, 2014-01, Vol.19 (6), p.579-586</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c347t-5e84fb7ad6624beafd67a953197b1ecc55bb50be4644c1b04ce6a554a701bffa3</citedby><cites>FETCH-LOGICAL-c347t-5e84fb7ad6624beafd67a953197b1ecc55bb50be4644c1b04ce6a554a701bffa3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24464590$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bunupuradah, Torsak</creatorcontrib><creatorcontrib>Bowonwattanuwong, Chureeratana</creatorcontrib><creatorcontrib>Jirajariyavej, Supunnee</creatorcontrib><creatorcontrib>Munsakul, Warangkana</creatorcontrib><creatorcontrib>Klinbuayaem, Virat</creatorcontrib><creatorcontrib>Sophonphan, Jiratchaya</creatorcontrib><creatorcontrib>Mahanontharit, Apicha</creatorcontrib><creatorcontrib>Hirschel, Bernard</creatorcontrib><creatorcontrib>Ruxrungtham, Kiat</creatorcontrib><creatorcontrib>Ananworanich, Jintanat</creatorcontrib><creatorcontrib>HIV STAR Study team</creatorcontrib><creatorcontrib>the HIV STAR Study team</creatorcontrib><title>HIV-1 genital shedding in HIV-infected patients randomized to second-line lopinavir/ritonavir monotherapy versus tenofovir/lamivudine/lopinavir/ritonavir</title><title>Antiviral therapy</title><addtitle>Antivir Ther</addtitle><description>HIV-1 shedding in genital secretions is associated with HIV transmission risk. Limited data exist on the effect of second-line lopinavir/ritonavir monotherapy (mLPV/r) on genital secretion of HIV RNA.
We measured HIV-1 in genital secretions of HIV-infected adults at time of failure from non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimens and at 48 weeks after being randomized to second-line mLPV/r versus tenofovir/lamivudine/LPV/r (TDF/3TC/LPV/r). Plasma and genital secretion (semen, vaginal swab) HIV RNA was quantified by the CobasAmpliprep/TaqMan assay.
Forty enrolled (15 on mLPV/r and 25 on TDF/3TC/LPV/r). Median age was 37.8 years and 35% were male. Median baseline CD4(+) T-cell count was 222 cells/mm(3), plasma HIV RNA was 4.1 log10 copies/ml and genital secretion HIV RNA was 2.3 log10 copies/ml. At week 48, the proportion of patients with plasma HIV RNA<50 copies/ml was 13/15 (87%) in mLPV/r and 21/25 (84%) in TDF/3TC/LPV/r arms. Median genital HIV RNA was significantly decreased from baseline in both arms (P=0.009 in mLPV/r and P=0.001 in TDF/3TC/LPV/r). In subjects with suppressed plasma HIV RNA, 12/34 (35%; 6/13 [46%] in the mLPV/r and 6/21 [29%] in the TDF/3TC/LPV/r arms) had detectable HIV RNA (range 74-957 copies/ml) in the genital secretions (P=0.41). By multivariate analysis, the only predictor of having genital HIV RNA>50 copies/ml at week 48 was baseline genital secretion HIV RNA>50 copies/ml (P=0.049).
LPV/r either given alone or in combination with TDF/3TC as second-line treatment achieved high genital secretion HIV RNA suppression rate. Genital secretion HIV RNA remained detectable at low levels in one-third of patients with suppressed plasma viraemia.</description><subject>Adenine - analogs & derivatives</subject><subject>Adult</subject><subject>Anti-HIV Agents - pharmacology</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Antiretroviral Therapy, Highly Active</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Genitalia - virology</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - virology</subject><subject>HIV-1 - drug effects</subject><subject>HIV-1 - physiology</subject><subject>Human immunodeficiency virus</subject><subject>Human immunodeficiency virus 1</subject><subject>Humans</subject><subject>Lamivudine</subject><subject>Lopinavir</subject><subject>Male</subject><subject>Organophosphonates</subject><subject>Risk Factors</subject><subject>Ritonavir</subject><subject>Tenofovir</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Viral Load</subject><subject>Virus Shedding</subject><issn>1359-6535</issn><issn>2040-2058</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkcFO3DAQhi3UqixQ8QaVb-0l7Di24-RYoRZWArUH4BrZzgRcJXZqOyvBm_C2zcLSU6WeZjTzzf9r9BNyyuCM15KtN9c_S8XVAVmVIKAoQdbvyIpx2RSV5PKQHKX0C6CsG4AP5LAUohKygRV5vtzcFYzeo3dZDzQ9YNc5f0-dp7uN8z3ajB2ddHboc6JR-y6M7mmZ5UAT2uC7YnAe6RAm5_XWxXV0Obx0dAw-5AeMenqkW4xpTjSjD33YYYMe3XZe7HD9j9sT8r7XQ8KP-3pMbr9_uzm_LK5-XGzOv14VlguVC4m16I3SXVWVwqDuu0rpRnLWKMPQWimNkWBweVhYZkBYrLSUQitgpu81PyZfXnWnGH7PmHI7umRxGLTHMKeWKcVrroDL_6MVlwB1WcGCfn5FbQwpRezbKbpRx8eWQbuLrN1HtpCf9qKzGbH7y71lxP8AnQKVLg</recordid><startdate>20140101</startdate><enddate>20140101</enddate><creator>Bunupuradah, Torsak</creator><creator>Bowonwattanuwong, Chureeratana</creator><creator>Jirajariyavej, Supunnee</creator><creator>Munsakul, Warangkana</creator><creator>Klinbuayaem, Virat</creator><creator>Sophonphan, Jiratchaya</creator><creator>Mahanontharit, Apicha</creator><creator>Hirschel, Bernard</creator><creator>Ruxrungtham, Kiat</creator><creator>Ananworanich, Jintanat</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7U9</scope><scope>H94</scope></search><sort><creationdate>20140101</creationdate><title>HIV-1 genital shedding in HIV-infected patients randomized to second-line lopinavir/ritonavir monotherapy versus tenofovir/lamivudine/lopinavir/ritonavir</title><author>Bunupuradah, Torsak ; Bowonwattanuwong, Chureeratana ; Jirajariyavej, Supunnee ; Munsakul, Warangkana ; Klinbuayaem, Virat ; Sophonphan, Jiratchaya ; Mahanontharit, Apicha ; Hirschel, Bernard ; Ruxrungtham, Kiat ; Ananworanich, Jintanat</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c347t-5e84fb7ad6624beafd67a953197b1ecc55bb50be4644c1b04ce6a554a701bffa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adenine - analogs & derivatives</topic><topic>Adult</topic><topic>Anti-HIV Agents - pharmacology</topic><topic>Anti-HIV Agents - therapeutic use</topic><topic>Antiretroviral Therapy, Highly Active</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Genitalia - virology</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - virology</topic><topic>HIV-1 - drug effects</topic><topic>HIV-1 - physiology</topic><topic>Human immunodeficiency virus</topic><topic>Human immunodeficiency virus 1</topic><topic>Humans</topic><topic>Lamivudine</topic><topic>Lopinavir</topic><topic>Male</topic><topic>Organophosphonates</topic><topic>Risk Factors</topic><topic>Ritonavir</topic><topic>Tenofovir</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Viral Load</topic><topic>Virus Shedding</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bunupuradah, Torsak</creatorcontrib><creatorcontrib>Bowonwattanuwong, Chureeratana</creatorcontrib><creatorcontrib>Jirajariyavej, Supunnee</creatorcontrib><creatorcontrib>Munsakul, Warangkana</creatorcontrib><creatorcontrib>Klinbuayaem, Virat</creatorcontrib><creatorcontrib>Sophonphan, Jiratchaya</creatorcontrib><creatorcontrib>Mahanontharit, Apicha</creatorcontrib><creatorcontrib>Hirschel, Bernard</creatorcontrib><creatorcontrib>Ruxrungtham, Kiat</creatorcontrib><creatorcontrib>Ananworanich, Jintanat</creatorcontrib><creatorcontrib>HIV STAR Study team</creatorcontrib><creatorcontrib>the HIV STAR Study team</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>Antiviral therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bunupuradah, Torsak</au><au>Bowonwattanuwong, Chureeratana</au><au>Jirajariyavej, Supunnee</au><au>Munsakul, Warangkana</au><au>Klinbuayaem, Virat</au><au>Sophonphan, Jiratchaya</au><au>Mahanontharit, Apicha</au><au>Hirschel, Bernard</au><au>Ruxrungtham, Kiat</au><au>Ananworanich, Jintanat</au><aucorp>HIV STAR Study team</aucorp><aucorp>the HIV STAR Study team</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>HIV-1 genital shedding in HIV-infected patients randomized to second-line lopinavir/ritonavir monotherapy versus tenofovir/lamivudine/lopinavir/ritonavir</atitle><jtitle>Antiviral therapy</jtitle><addtitle>Antivir Ther</addtitle><date>2014-01-01</date><risdate>2014</risdate><volume>19</volume><issue>6</issue><spage>579</spage><epage>586</epage><pages>579-586</pages><issn>1359-6535</issn><eissn>2040-2058</eissn><abstract>HIV-1 shedding in genital secretions is associated with HIV transmission risk. Limited data exist on the effect of second-line lopinavir/ritonavir monotherapy (mLPV/r) on genital secretion of HIV RNA.
We measured HIV-1 in genital secretions of HIV-infected adults at time of failure from non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimens and at 48 weeks after being randomized to second-line mLPV/r versus tenofovir/lamivudine/LPV/r (TDF/3TC/LPV/r). Plasma and genital secretion (semen, vaginal swab) HIV RNA was quantified by the CobasAmpliprep/TaqMan assay.
Forty enrolled (15 on mLPV/r and 25 on TDF/3TC/LPV/r). Median age was 37.8 years and 35% were male. Median baseline CD4(+) T-cell count was 222 cells/mm(3), plasma HIV RNA was 4.1 log10 copies/ml and genital secretion HIV RNA was 2.3 log10 copies/ml. At week 48, the proportion of patients with plasma HIV RNA<50 copies/ml was 13/15 (87%) in mLPV/r and 21/25 (84%) in TDF/3TC/LPV/r arms. Median genital HIV RNA was significantly decreased from baseline in both arms (P=0.009 in mLPV/r and P=0.001 in TDF/3TC/LPV/r). In subjects with suppressed plasma HIV RNA, 12/34 (35%; 6/13 [46%] in the mLPV/r and 6/21 [29%] in the TDF/3TC/LPV/r arms) had detectable HIV RNA (range 74-957 copies/ml) in the genital secretions (P=0.41). By multivariate analysis, the only predictor of having genital HIV RNA>50 copies/ml at week 48 was baseline genital secretion HIV RNA>50 copies/ml (P=0.049).
LPV/r either given alone or in combination with TDF/3TC as second-line treatment achieved high genital secretion HIV RNA suppression rate. Genital secretion HIV RNA remained detectable at low levels in one-third of patients with suppressed plasma viraemia.</abstract><cop>England</cop><pmid>24464590</pmid><doi>10.3851/IMP2737</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Antiviral therapy, 2014-01, Vol.19 (6), p.579-586 |
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| language | eng |
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| source | MEDLINE; SAGE Open Access; EZB Electronic Journals Library |
| subjects | Adenine - analogs & derivatives Adult Anti-HIV Agents - pharmacology Anti-HIV Agents - therapeutic use Antiretroviral Therapy, Highly Active Female Follow-Up Studies Genitalia - virology HIV Infections - drug therapy HIV Infections - virology HIV-1 - drug effects HIV-1 - physiology Human immunodeficiency virus Human immunodeficiency virus 1 Humans Lamivudine Lopinavir Male Organophosphonates Risk Factors Ritonavir Tenofovir Time Factors Treatment Outcome Viral Load Virus Shedding |
| title | HIV-1 genital shedding in HIV-infected patients randomized to second-line lopinavir/ritonavir monotherapy versus tenofovir/lamivudine/lopinavir/ritonavir |
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