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Predictors of low‐level HIV viraemia and virological failure in the era of integrase inhibitors: A Spanish nationwide cohort

Martínez, Cristina ; Moreno, Santiago ; Dalmau, David ; García, Federico ; Iribarren, José Antonio ; Rubio, Rafael ; González, Juan ; Muñoz‐Fernández, M Ángeles ; Iniesta, Carlos ; Muñoz‐Fernández, M Ángeles ; Sánchez‐Payá, José ; Rodríguez, Juan Carlos ; López Lirola, Ana ; García, Dácil ; Hernández, María Inmaculada ; Domínguez, Lourdes ; Rial Crestelo, David ; Bermejo, Laura ; Santacreu, Mireia ; Aramburu, María José ; Goenaga, Miguel Ángel ; Colomé, Joan Gregori ; Pascual, Rafael ; Agullo Re, Vanessa ; García Abellán, Javier ; Gutiérrez, Isabel ; Ramírez, Margarita ; Padilla, Belén ; Aldamiz‐Echevarría, Teresa ; Olona, Montserrat ; Rull, Anna ; Rodríguez‐Gallego, Esther ; López‐Dupla, Miguel ; Montero Alonso, Marta ; Tasias Pitarch, María ; Calabuig Muñoz, Eva ; Fernández Navarro, Juan ; Arnalich, Francisco ; Arribas, José Ramón ; Herranz, Pedro ; Esteban Micán, Rafael ; Montes, María Luisa ; Pérez‐Valero, Ignacio ; Blanco, José Ramón ; Ibarra, Valvanera ; Metola, Luis ; Arazo, Piedad ; Sampériz, Gloria ; Dalmau, David ; Sanmartí, Montse ; Martinez‐Lacasa, Javier ; Aiello, Francesco ; Gracia Ruiz de Alda, María ; Amengual, María José ; Cervantes García, Manel ; Calzado Isbert, Sonia ; Navarro Vilasaro, Marta ; Sarria Cepeda, Cristina ; Casado Osorio, José Luis ; Dronda Núñez, Fernando ; Pérez Elías, Maria Jesús ; Vivancos Gallego, María Jesús ; Martínez Sanz, Javier ; Alcaraz, María Jose ; Villalba, María del Carmen ; Muñoz Medina, Leopoldo ; Chueca, Natalia ; Martínez‐Montes, Clara ; Guerrero Beltrán, Carlos ; Rodríguez, Carmen ; Puerta, Teresa ; Murillas, Javier ; Vilchez, Helem H ; Martin, Maria Luisa ; Payeras, Antoni ; Gonzalez‐Domenec, Carmen Maria ; Silva, Ana ; Ribera, Esteban ; Olalla Sierra, Julián ; Prada, José Luis ; García de Lomas Guerrero, José María ; Castro Iglesias, Ángeles ; Baraia‐Etxaburu, Josu Mirena ; Ferrero Beneitez, Oscar Luis ; Lopez, Miriam ; Galera, Carlos ; Albendin, Helena ; Merlos, María Angustias ; Vidal, Asunción ; Amador, Concha ; Ena, Javier ; Martín Rodrigo, Dolores ; Mohamed‐Balghata, Mohamed Omar ; Pérez‐Somarriba Moreno, Juncal ; Górgolas, Miguel ; Cabello, Alfonso ; Sanz Moreno, José ; Frias Casas, Mario ; Pérez, Alexandre ; Ocampo, Antonio

HIV medicine, 2022-09, Vol.23 (8), p.825-836 [Periódico revisado por pares]

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Predictors of low‐level HIV viraemia and virological failure in the era of integrase inhibitors: A Spanish nationwide cohort
Autor: Martínez, Cristina ; Moreno, Santiago ; Dalmau, David ; García, Federico ; Iribarren, José Antonio ; Rubio, Rafael ; González, Juan ; Muñoz‐Fernández, M Ángeles ; Iniesta, Carlos ; Muñoz‐Fernández, M Ángeles ; Sánchez‐Payá, José ; Rodríguez, Juan Carlos ; López Lirola, Ana ; García, Dácil ; Hernández, María Inmaculada ; Domínguez, Lourdes ; Rial Crestelo, David ; Bermejo, Laura ; Santacreu, Mireia ; Aramburu, María José ; Goenaga, Miguel Ángel ; Colomé, Joan Gregori ; Pascual, Rafael ; Agullo Re, Vanessa ; García Abellán, Javier ; Gutiérrez, Isabel ; Ramírez, Margarita ; Padilla, Belén ; Aldamiz‐Echevarría, Teresa ; Olona, Montserrat ; Rull, Anna ; Rodríguez‐Gallego, Esther ; López‐Dupla, Miguel ; Montero Alonso, Marta ; Tasias Pitarch, María ; Calabuig Muñoz, Eva ; Fernández Navarro, Juan ; Arnalich, Francisco ; Arribas, José Ramón ; Herranz, Pedro ; Esteban Micán, Rafael ; Montes, María Luisa ; Pérez‐Valero, Ignacio ; Blanco, José Ramón ; Ibarra, Valvanera ; Metola, Luis ; Arazo, Piedad ; Sampériz, Gloria ; Dalmau, David ; Sanmartí, Montse ; Martinez‐Lacasa, Javier ; Aiello, Francesco ; Gracia Ruiz de Alda, María ; Amengual, María José ; Cervantes García, Manel ; Calzado Isbert, Sonia ; Navarro Vilasaro, Marta ; Sarria Cepeda, Cristina ; Casado Osorio, José Luis ; Dronda Núñez, Fernando ; Pérez Elías, Maria Jesús ; Vivancos Gallego, María Jesús ; Martínez Sanz, Javier ; Alcaraz, María Jose ; Villalba, María del Carmen ; Muñoz Medina, Leopoldo ; Chueca, Natalia ; Martínez‐Montes, Clara ; Guerrero Beltrán, Carlos ; Rodríguez, Carmen ; Puerta, Teresa ; Murillas, Javier ; Vilchez, Helem H ; Martin, Maria Luisa ; Payeras, Antoni ; Gonzalez‐Domenec, Carmen Maria ; Silva, Ana ; Ribera, Esteban ; Olalla Sierra, Julián ; Prada, José Luis ; García de Lomas Guerrero, José María ; Castro Iglesias, Ángeles ; Baraia‐Etxaburu, Josu Mirena ; Ferrero Beneitez, Oscar Luis ; Lopez, Miriam ; Galera, Carlos ; Albendin, Helena ; Merlos, María Angustias ; Vidal, Asunción ; Amador, Concha ; Ena, Javier ; Martín Rodrigo, Dolores ; Mohamed‐Balghata, Mohamed Omar ; Pérez‐Somarriba Moreno, Juncal ; Górgolas, Miguel ; Cabello, Alfonso ; Sanz Moreno, José ; Frias Casas, Mario ; Pérez, Alexandre ; Ocampo, Antonio
Assuntos: Acquired immune deficiency syndrome ; AIDS ; Antiretroviral agents ; Antiretroviral therapy ; antiretroviral treatment‐naïve ; CD4 antigen ; CD8 antigen ; HIV ; HIV‐1 ; Human immunodeficiency virus ; Integrase ; integrase inhibitors ; low‐level viraemia ; Non-nucleoside reverse transcriptase inhibitors ; Nucleoside reverse transcriptase inhibitors ; Protease inhibitors ; Proteinase inhibitors ; Public health ; Regression analysis ; Regression models ; RNA-directed DNA polymerase ; Statistical analysis ; Viremia ; virological failure
É parte de: HIV medicine, 2022-09, Vol.23 (8), p.825-836
Notas: Funding information
Correction added on 28 March 2022, after first online publication: the affiliation of Antonio Rivero has been corrected in this version.
Correction added on 17 June 2022, after first online publication: the order of author affiliations was updated.
The members of the CoRIS Study Group are given in the
This work was supported by Plan Estatal de I+D+I 2013‐2016 and 2017‐2020 and co‐financed by the Instituto de Salud Carlos III (ISCIII)‐Subdirección General de Evaluación y Fomento de la Investigación del Fondo Europeo de Desarrollo Regional (FEDER) (PI16/02159, PI19/00747); RETICS, Red de Investigación en SIDA (RD16/0025/0026) and Fundación Biomédica Galicia Sur.
Eva Poveda and Josep M. Llibre share senior authorship and have contributed equally to this work.
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Descrição: Objectives To pinpoint factors associated with low‐level viraemia (LLV) and virological failure (VF) in people living with HIV in the era of high‐efficacy antiretroviral treatment (ART) and widespread use of integrase strand transfer inhibitor (INSTIs)‐based ART. Methods We included adults aged > 18 years starting their first ART between 2015 and 2018 in the Spanish HIV/AIDS Research Network National Cohort (CoRIS). Low‐level viraemia was defined as plasma viral load (pVL) of 50–199 copies/mL at weeks 48 and 72 and VF was defined as pVL ≥ 50 copies/mL at week 48 and pVL ≥ 200 copies/mL at week 72. Multivariable logistic regression models assessed the impact on LLV and VF of baseline CD4 T‐cell count, CD4/CD8 T‐cell ratio and pVL, initial ART classes, age at ART initiation, time between HIV diagnosis and ART initiation, gender and transmission route. Results Out of 4186 participants, 3120 (76.0%) started INSTIs, 455 (11.1%) started boosted protease inhibitors (bPIs) and 443 (10.8%) started nonnucleoside reverse transcriptase inhibitors (NNRTIs), either of them with two nucleos(t)ide reverse transcriptase inhibitors (NRTIs). Low‐level viraemia was met in 2.5% of participants and VF in 4.3%. There were no significant differences throughout the years for both virological outcomes. Baseline HIV‐1 RNA > 5 log10 copies/mL was the only consistent predictor of higher risk of LLV [adjusted odds ratio (aOR) = 9.8, 95% confidence interval (CI): 2.0–48.3] and VF (aOR = 5.4, 95% CI: 1.9–15.1), even in participants treated with INSTIs. Conclusions The rates of LLV and VF were low but remained steady throughout the years. Baseline HIV‐1 RNA > 5 log10 copies/mL showed a persistent association with LLV and VF even in participants receiving INSTIs.
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Predictors of low‐level HIV viraemia and virological failure in the era of integrase inhibitors: A Spanish nationwide cohort

England: Wiley Subscription Services, Inc

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