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- Title
DORAVIR: a French national survey of people with HIV-1 treated with an antiretroviral regimen including doravirine.
- Authors
Soulie, Cathia; Balde, Aliou; Fofana, Djeneba; Charpentier, Charlotte; Bonnafous, Pascale; Sourice, Justine; Monte, Anne De; Avettand-Fenoel, Véronique; Guillou-Guillemette, Hélène Le; Bocket, Laurence; Raymond, Stéphanie; Juillet, Stéphanie Marque; Trabaud, Mary-Anne; Montes, Brigitte; Maillard, Anne; Hartard, Cédric; Alessandri-Gradt, Elodie; Brochot, Etienne; Signori-Schmuck, Anne; Assoumou, Lambert
- Abstract
Background Doravirine is the latest NNRTI to be approved for the treatment of HIV-1 and has a different resistance profile from first-generation NNRTIs. Our aim was to investigate the virological efficacy of antiretroviral treatment including doravirine in people living with HIV-1 (PLWHIV), the factors associated with virological failure (VF) and those associated with the emergence of reverse transcriptase (RT) mutations in the case of VF. Methods A retrospective national survey of PLWHIV who were either naive or experienced on antiretroviral treatment including doravirine was conducted. VF was defined as two consecutive plasma viral loads (VLs) of ≥50 copies/mL or one VL of ≥200 copies/mL. Genotypic resistance tests were interpreted using the Stanford (v9.4.1) and ANRS (v33) algorithms. Results Of the 589 PLWHIV treated with a doravirine-containing regimen, 8.5% were naive and 91.5% had prior antiretroviral experience; 56.9% were infected with HIV-1 B subtype. Overall, 88.3% and 85.1% of participants were virologically controlled at Month (M)3 and M6 of doravirine treatment, respectively. In multivariable analysis, CRF02_AG subtype, higher zenith plasma HIV-1 RNA VL, doravirine initiation in the context of failure and baseline V179D mutation presence were associated with VF. Among 88 PLWHIV who experienced virological failure at M6, 15.9% had a median of 2 (IQR 1–3) HIV RT mutations. In multivariable analysis, the only factor associated with the occurrence of mutations was a genotypic sensitivity score that was not fully sensitive. Conclusions This study is one of the largest to characterize the virological efficacy of doravirine-containing regimens in clinical practice and to identify factors associated with VF or emergence of resistance mutations that should be considered in clinical management.
- Subjects
VIRAL load; ANTIRETROVIRAL agents; HIV; GENOTYPES; RALTEGRAVIR; RNA
- Publication
Journal of Antimicrobial Chemotherapy (JAC), 2024, Vol 79, Issue 8, p1974
- ISSN
0305-7453
- Publication type
Article
- DOI
10.1093/jac/dkae194