Four-days-a-week antiretroviral maintenance therapy in virologically controlled HIV-1-infected adults: the ANRS 162-4D trial - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Journal of Antimicrobial Chemotherapy Année : 2018

Four-days-a-week antiretroviral maintenance therapy in virologically controlled HIV-1-infected adults: the ANRS 162-4D trial

Olivier Bouchaud
  • Fonction : Auteur
  • PersonId : 948528
Jacques Izopet
Christian Perronne
  • Fonction : Auteur
  • PersonId : 1013954
Anrs 162-4d Study Group
  • Fonction : Auteur
Irène Zamord
  • Fonction : Collaborateur
Cécile Goujard
  • Fonction : Collaborateur
Frédéric Fourreau
  • Fonction : Collaborateur
Véronique Joly
  • Fonction : Collaborateur
Bao Phung
  • Fonction : Collaborateur
Laurence Weiss
  • Fonction : Collaborateur
Lio Collias
  • Fonction : Collaborateur
Claire Rouzaud
  • Fonction : Collaborateur
Fatima Touam
  • Fonction : Collaborateur
Luminita Schneider
  • Fonction : Collaborateur
Stéphanie Landowski
  • Fonction : Collaborateur
Huguette Berthe
  • Fonction : Collaborateur
Karine Lacombe
Jean-Luc Meynard
  • Fonction : Collaborateur
Julie Chas
  • Fonction : Collaborateur
Pélagie Thibault
  • Fonction : Collaborateur
Arnaud de La Blanchardiere
  • Fonction : Collaborateur
Sylvie Dargère
  • Fonction : Collaborateur
Alain Devidas
  • Fonction : Collaborateur
Amélie Chabrol
  • Fonction : Collaborateur
Lionel Piroth
  • Fonction : Collaborateur
  • PersonId : 1136581
Sandrine Gohier
  • Fonction : Collaborateur
André Cabie
Mathilde Pircher
  • Fonction : Collaborateur
David Zucman
Dominique Bornarel
  • Fonction : Collaborateur
Louis Bernard
  • Fonction : Collaborateur
Adrien Lemaignen
  • Fonction : Collaborateur
Pierre Delobel
  • Fonction : Collaborateur
Noemie Biezunski
  • Fonction : Collaborateur
Aida Benalicherif
  • Fonction : Collaborateur
Babacar Sylla
  • Fonction : Collaborateur
Severine Gibowski
  • Fonction : Collaborateur
Soizic Le Mestre
  • Fonction : Collaborateur
Jean-François Delfraissy
  • Fonction : Collaborateur

Résumé

Background: Intermittent treatment could improve the convenience, tolerability and cost of ART, as well as patients' quality of life. We conducted a 48 week multicentre study of a 4-days-a-week antiretroviral regimen in adults with controlled HIV-1-RNA plasma viral load (VL). Methods: Eligible patients were adults with VL < 50 copies/mL for at least 1 year on triple therapy with a ritonavir-boosted PI (PI/r) or an NNRTI. The study protocol consisted of the same regimen taken on four consecutive days per week followed by a 3 day drug interruption. The primary outcome was the proportion of participants remaining in the strategy with VL < 50 copies/mL up to week 48. The study was designed to show an observed success rate of > 90%, with a power of 87% and a 5% type 1 error. The study was registered with ClinicalTrials.gov (NCT02157311) and EudraCT (2014-000146-29). Results: One hundred patients (82 men), median age 47 years (IQR 40-53), were included. They had been receiving ART for a median of 5.1 (IQR 2.9-9.3) years and had a median CD4 cell count of 665 (IQR 543-829) cells/mm3. The ongoing regimen included PI/r in 29 cases and NNRTI in 71 cases. At 48 weeks, 96% of participants (95% CI 90%-98%) had no failure while remaining on the 4-days-a-week regimen. Virological failure occurred in three participants, who all resumed daily treatment and became resuppressed. One participant stopped the strategy. No severe treatment-related events occurred. Conclusions: Antiretroviral maintenance therapy 4 days a week was effective for 48 weeks in 96% of patients, leading to potential reduction of long-term toxicities, high adherence to the antiretroviral regimen and drug cost saving.

Dates et versions

hal-01740290 , version 1 (21-03-2018)

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Citer

Pierre de Truchis, Lambert Assoumou, Roland Landman, Dominique Mathez, Damien Le Dû, et al.. Four-days-a-week antiretroviral maintenance therapy in virologically controlled HIV-1-infected adults: the ANRS 162-4D trial. Journal of Antimicrobial Chemotherapy, 2018, 73 (3), pp.738 - 747. ⟨10.1093/jac/dkx434⟩. ⟨hal-01740290⟩
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