We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Darunavir/ritonavir monotherapy at a low dose (600/100 mg/day) in HIV-1-infected individuals with suppressed HIV viraemia.
- Authors
Peytavin, G.; Seang, S.; Schneider, L.; Calin, R.; Caby, F.; Valantin, M. A.; Tubiana, R.; Katlama, C.; Assoumou, L.; Nguyen, T.; Soulie, C.; Marcelin, A. G.; Lê, M. P.
- Abstract
<bold>Background: </bold>Darunavir/ritonavir is a potent PI with a high genetic barrier and pharmacological robustness favourably investigated as monotherapy. Whether darunavir could be dose reduced in the context of monotherapy deserves investigation.<bold>Methods: </bold>Patients with HIV suppressed viraemia (plasma viral load <50 copies/mL for 12 months) under ART who had switched to darunavir/ritonavir monotherapy at 600/100 mg/day between 2013 and 2015 were included in this observational 48 week single-centre study. The primary outcome was the proportion of patients with virological success (defined as plasma viral load <50 copies/mL) at week 24. Secondary outcomes included treatment strategy success and resistance.<bold>Results: </bold>Thirty-one patients were included with the following baseline characteristics [median (IQR)]: age 52 years (47-57), CD4+ 649 cells/mm3 (463-813), ART duration 16.3 years (9.2-22.3), nadir CD4+ 195 cells/mm3 (144-261) and duration of HIV suppression 7.8 years (4.8-9.7). Prior to switch, ART consisted of PI monotherapy for 28 of 31 patients [darunavir/ritonavir 800/100 mg/day (n = 26), lopinavir/ritonavir (n = 1) and atazanavir/ritonavir (n = 1)] and a triple drug regimen for 3 of 31 patients. Within the 48 weeks of follow-up, no virological failure occurred and two patients discontinued 600/100 mg of darunavir/ritonavir due to side effects at week 16 and 40, leading to a virological suppression rate of 100% (95% CI = 89-100) at weeks 24 and 48. Strategy success rates were 96.8% (95% CI = 83.3-99.9) at week 24 and 93.5% (95% CI = 78.6-99.2) at week 48. Median (IQR) Ctrough values of 800/100 mg of darunavir/ritonavir and 600/100 mg of darunavir/ritonavir were 1537 ng/mL (1286-1724) and 1255 ng/mL (873-2161), respectively.<bold>Conclusions: </bold>A lower dose of darunavir/ritonavir used as monotherapy (600/100 mg/day) was highly effective in virologically suppressed HIV-infected patients. Further studies are needed to confirm these data.
- Subjects
DARUNAVIR; RITONAVIR; VIREMIA; HIV; DRUG resistance; DRUG resistance in microorganisms; HIV infections; VIRAL load; TREATMENT effectiveness; ANTI-HIV agents
- Publication
Journal of Antimicrobial Chemotherapy (JAC), 2018, Vol 73, Issue 2, p490
- ISSN
0305-7453
- Publication type
journal article
- DOI
10.1093/jac/dkx417