Plasma Human Immunodeficiency Virus 1 RNA and CD4+T-Cell Counts Are Determinants of Virological Nonsuppression Outcomes with Initial Integrase Inhibitor-Based Regimens: A Prospective RESPOND Cohort Study

Research output: Contribution to journal › Journal article › Research › peer-review

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Plasma Human Immunodeficiency Virus 1 RNA and CD4+T-Cell Counts Are Determinants of Virological Nonsuppression Outcomes with Initial Integrase Inhibitor-Based Regimens : A Prospective RESPOND Cohort Study. / Álvarez, Hortensia; Mocroft, Amanda; Ryom, Lene; Neesgaard, Bastian; Edwards, Simon; Svedhem, Veronica; Günthard, Huldrych F.; Zangerle, Robert; Smith, Colette; Castagna, Antonella; D'Arminio Monforte, Antonella; Wit, Ferdinand; Stecher, Melanie; Lehman, Clara; Mussini, Cristina; Fontas, Eric; González, Eva; Wasmuth, Jan Christian; Sönnerborg, Anders; De Wit, Stephane; Chkhartishvili, Nikoloz; Stephan, Christoph; Petoumenos, Kathy; Jaschinski, Nadine; Vannappagari, Vani; Gallant, Joel; Young, Lital; Volny Anne, Alain; Greenberg, Lauren; Martín-Iguacel, Raquel; Poveda, Eva; Llibre, Josep M.

In: Clinical Infectious Diseases, Vol. 77, No. 4, 2023, p. 593-605.

Research output: Contribution to journal › Journal article › Research › peer-review

Harvard

Álvarez, H, Mocroft, A, Ryom, L, Neesgaard, B, Edwards, S, Svedhem, V, Günthard, HF, Zangerle, R, Smith, C, Castagna, A, D'Arminio Monforte, A, Wit, F, Stecher, M, Lehman, C, Mussini, C, Fontas, E, González, E, Wasmuth, JC, Sönnerborg, A, De Wit, S, Chkhartishvili, N, Stephan, C, Petoumenos, K, Jaschinski, N, Vannappagari, V, Gallant, J, Young, L, Volny Anne, A, Greenberg, L, Martín-Iguacel, R, Poveda, E & Llibre, JM 2023, 'Plasma Human Immunodeficiency Virus 1 RNA and CD4+T-Cell Counts Are Determinants of Virological Nonsuppression Outcomes with Initial Integrase Inhibitor-Based Regimens: A Prospective RESPOND Cohort Study', Clinical Infectious Diseases, vol. 77, no. 4, pp. 593-605. https://doi.org/10.1093/cid/ciad219

APA

Álvarez, H., Mocroft, A., Ryom, L., Neesgaard, B., Edwards, S., Svedhem, V., Günthard, H. F., Zangerle, R., Smith, C., Castagna, A., D'Arminio Monforte, A., Wit, F., Stecher, M., Lehman, C., Mussini, C., Fontas, E., González, E., Wasmuth, J. C., Sönnerborg, A., ... Llibre, J. M. (2023). Plasma Human Immunodeficiency Virus 1 RNA and CD4+T-Cell Counts Are Determinants of Virological Nonsuppression Outcomes with Initial Integrase Inhibitor-Based Regimens: A Prospective RESPOND Cohort Study. Clinical Infectious Diseases, 77(4), 593-605. https://doi.org/10.1093/cid/ciad219

Vancouver

Álvarez H, Mocroft A, Ryom L, Neesgaard B, Edwards S, Svedhem V et al. Plasma Human Immunodeficiency Virus 1 RNA and CD4+T-Cell Counts Are Determinants of Virological Nonsuppression Outcomes with Initial Integrase Inhibitor-Based Regimens: A Prospective RESPOND Cohort Study. Clinical Infectious Diseases. 2023;77(4):593-605. https://doi.org/10.1093/cid/ciad219

Author

Álvarez, Hortensia ; Mocroft, Amanda ; Ryom, Lene ; Neesgaard, Bastian ; Edwards, Simon ; Svedhem, Veronica ; Günthard, Huldrych F. ; Zangerle, Robert ; Smith, Colette ; Castagna, Antonella ; D'Arminio Monforte, Antonella ; Wit, Ferdinand ; Stecher, Melanie ; Lehman, Clara ; Mussini, Cristina ; Fontas, Eric ; González, Eva ; Wasmuth, Jan Christian ; Sönnerborg, Anders ; De Wit, Stephane ; Chkhartishvili, Nikoloz ; Stephan, Christoph ; Petoumenos, Kathy ; Jaschinski, Nadine ; Vannappagari, Vani ; Gallant, Joel ; Young, Lital ; Volny Anne, Alain ; Greenberg, Lauren ; Martín-Iguacel, Raquel ; Poveda, Eva ; Llibre, Josep M. / Plasma Human Immunodeficiency Virus 1 RNA and CD4+T-Cell Counts Are Determinants of Virological Nonsuppression Outcomes with Initial Integrase Inhibitor-Based Regimens : A Prospective RESPOND Cohort Study. In: Clinical Infectious Diseases. 2023 ; Vol. 77, No. 4. pp. 593-605.

Bibtex

@article{11beb44046cc4857a5f4dd91a1517db7,
title = "Plasma Human Immunodeficiency Virus 1 RNA and CD4+T-Cell Counts Are Determinants of Virological Nonsuppression Outcomes with Initial Integrase Inhibitor-Based Regimens: A Prospective RESPOND Cohort Study",
abstract = "Background: There are conflicting data regarding baseline determinants of virological nonsuppression outcomes in persons with human immunodeficiency virus (HIV) starting antiretroviral treatment (ART). We evaluated the impact of different baseline variables in the RESPOND cohort. Methods: We included treatment-naive participants aged ≥18 who initiated 3-drug ART, in 2014-2020. We assessed the odds of virological suppression (VS) at weeks 48 and 96 using logistic regression. Viral blips, low-level viremia (LLV), residual viremia (RV), and virological failure (VF) rates were assessed using Cox regression. Results: Of 4310 eligible participants, 72% started integrase strand transfer inhibitor (INSTI)-based regimens. At 48 and 96 weeks, 91.0% and 93.3% achieved VS, respectively. At 48 weeks, Kaplan-Meier estimates of rates were 9.6% for viral blips, 2.1% for LLV, 22.2% for RV, and 2.1% for VF. Baseline HIV-1 RNA levels >100 000 copies/mL and CD4+ T-cell counts ≤200/μL were negatively associated with VS at weeks 48 (adjusted odds ratio, 0.51 [95% confidence interval,. 39-.68] and. 40 [.27-.58], respectively) and 96 and with significantly higher rates of blips, LLV, and RV. CD4+ T-cell counts ≤200/μL were associated with higher risk of VF (adjusted hazard ratio, 3.12 [95% confidence interval, 2.02-4.83]). Results were consistent in those starting INSTIs versus other regimens and those starting dolutegravir versus other INSTIs. Conclusions: Initial high HIV-1 RNA and low CD4+ T-cell counts are associated with lower rates of VS at 48 and 96 weeks and higher rates of viral blips, LLV, and RV. Low baseline CD4+ T-cell counts are associated with higher VF rates. These associations remain with INSTI-based and specifically with dolutegravir-based regimens. These findings suggest that the impact of these baseline determinants is independent of the ART regimen initiated. ",
keywords = "blip, integrase inhibitors, low-level viremia, residual viremia, virological failure",
author = "Hortensia {\'A}lvarez and Amanda Mocroft and Lene Ryom and Bastian Neesgaard and Simon Edwards and Veronica Svedhem and G{\"u}nthard, {Huldrych F.} and Robert Zangerle and Colette Smith and Antonella Castagna and {D'Arminio Monforte}, Antonella and Ferdinand Wit and Melanie Stecher and Clara Lehman and Cristina Mussini and Eric Fontas and Eva Gonz{\'a}lez and Wasmuth, {Jan Christian} and Anders S{\"o}nnerborg and {De Wit}, Stephane and Nikoloz Chkhartishvili and Christoph Stephan and Kathy Petoumenos and Nadine Jaschinski and Vani Vannappagari and Joel Gallant and Lital Young and {Volny Anne}, Alain and Lauren Greenberg and Raquel Mart{\'i}n-Iguacel and Eva Poveda and Llibre, {Josep M.}",
note = "Publisher Copyright: {\textcopyright} 2023 The Author(s).",
year = "2023",
doi = "10.1093/cid/ciad219",
language = "English",
volume = "77",
pages = "593--605",
journal = "Clinical Infectious Diseases",
issn = "1058-4838",
publisher = "Oxford University Press",
number = "4",

}

RIS

TY - JOUR

T1 - Plasma Human Immunodeficiency Virus 1 RNA and CD4+T-Cell Counts Are Determinants of Virological Nonsuppression Outcomes with Initial Integrase Inhibitor-Based Regimens

T2 - A Prospective RESPOND Cohort Study

AU - Álvarez, Hortensia

AU - Mocroft, Amanda

AU - Ryom, Lene

AU - Neesgaard, Bastian

AU - Edwards, Simon

AU - Svedhem, Veronica

AU - Günthard, Huldrych F.

AU - Zangerle, Robert

AU - Smith, Colette

AU - Castagna, Antonella

AU - D'Arminio Monforte, Antonella

AU - Wit, Ferdinand

AU - Stecher, Melanie

AU - Lehman, Clara

AU - Mussini, Cristina

AU - Fontas, Eric

AU - González, Eva

AU - Wasmuth, Jan Christian

AU - Sönnerborg, Anders

AU - De Wit, Stephane

AU - Chkhartishvili, Nikoloz

AU - Stephan, Christoph

AU - Petoumenos, Kathy

AU - Jaschinski, Nadine

AU - Vannappagari, Vani

AU - Gallant, Joel

AU - Young, Lital

AU - Volny Anne, Alain

AU - Greenberg, Lauren

AU - Martín-Iguacel, Raquel

AU - Poveda, Eva

AU - Llibre, Josep M.

N1 - Publisher Copyright: © 2023 The Author(s).

PY - 2023

Y1 - 2023

N2 - Background: There are conflicting data regarding baseline determinants of virological nonsuppression outcomes in persons with human immunodeficiency virus (HIV) starting antiretroviral treatment (ART). We evaluated the impact of different baseline variables in the RESPOND cohort. Methods: We included treatment-naive participants aged ≥18 who initiated 3-drug ART, in 2014-2020. We assessed the odds of virological suppression (VS) at weeks 48 and 96 using logistic regression. Viral blips, low-level viremia (LLV), residual viremia (RV), and virological failure (VF) rates were assessed using Cox regression. Results: Of 4310 eligible participants, 72% started integrase strand transfer inhibitor (INSTI)-based regimens. At 48 and 96 weeks, 91.0% and 93.3% achieved VS, respectively. At 48 weeks, Kaplan-Meier estimates of rates were 9.6% for viral blips, 2.1% for LLV, 22.2% for RV, and 2.1% for VF. Baseline HIV-1 RNA levels >100 000 copies/mL and CD4+ T-cell counts ≤200/μL were negatively associated with VS at weeks 48 (adjusted odds ratio, 0.51 [95% confidence interval,. 39-.68] and. 40 [.27-.58], respectively) and 96 and with significantly higher rates of blips, LLV, and RV. CD4+ T-cell counts ≤200/μL were associated with higher risk of VF (adjusted hazard ratio, 3.12 [95% confidence interval, 2.02-4.83]). Results were consistent in those starting INSTIs versus other regimens and those starting dolutegravir versus other INSTIs. Conclusions: Initial high HIV-1 RNA and low CD4+ T-cell counts are associated with lower rates of VS at 48 and 96 weeks and higher rates of viral blips, LLV, and RV. Low baseline CD4+ T-cell counts are associated with higher VF rates. These associations remain with INSTI-based and specifically with dolutegravir-based regimens. These findings suggest that the impact of these baseline determinants is independent of the ART regimen initiated.

AB - Background: There are conflicting data regarding baseline determinants of virological nonsuppression outcomes in persons with human immunodeficiency virus (HIV) starting antiretroviral treatment (ART). We evaluated the impact of different baseline variables in the RESPOND cohort. Methods: We included treatment-naive participants aged ≥18 who initiated 3-drug ART, in 2014-2020. We assessed the odds of virological suppression (VS) at weeks 48 and 96 using logistic regression. Viral blips, low-level viremia (LLV), residual viremia (RV), and virological failure (VF) rates were assessed using Cox regression. Results: Of 4310 eligible participants, 72% started integrase strand transfer inhibitor (INSTI)-based regimens. At 48 and 96 weeks, 91.0% and 93.3% achieved VS, respectively. At 48 weeks, Kaplan-Meier estimates of rates were 9.6% for viral blips, 2.1% for LLV, 22.2% for RV, and 2.1% for VF. Baseline HIV-1 RNA levels >100 000 copies/mL and CD4+ T-cell counts ≤200/μL were negatively associated with VS at weeks 48 (adjusted odds ratio, 0.51 [95% confidence interval,. 39-.68] and. 40 [.27-.58], respectively) and 96 and with significantly higher rates of blips, LLV, and RV. CD4+ T-cell counts ≤200/μL were associated with higher risk of VF (adjusted hazard ratio, 3.12 [95% confidence interval, 2.02-4.83]). Results were consistent in those starting INSTIs versus other regimens and those starting dolutegravir versus other INSTIs. Conclusions: Initial high HIV-1 RNA and low CD4+ T-cell counts are associated with lower rates of VS at 48 and 96 weeks and higher rates of viral blips, LLV, and RV. Low baseline CD4+ T-cell counts are associated with higher VF rates. These associations remain with INSTI-based and specifically with dolutegravir-based regimens. These findings suggest that the impact of these baseline determinants is independent of the ART regimen initiated.

KW - blip

KW - integrase inhibitors

KW - low-level viremia

KW - residual viremia

KW - virological failure

U2 - 10.1093/cid/ciad219

DO - 10.1093/cid/ciad219

M3 - Journal article

C2 - 37052343

AN - SCOPUS:85170276524

VL - 77

SP - 593

EP - 605

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

IS - 4

ER -

ID: 396731989