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Use of darunavir in HIV-1-infected individuals in routine clinical practice from 2012 to 2016 in France

Valérie Potard 1, 2 Ana Canestri 3 Sébastien Gallien 4 Dominique Costagliola 1, 2 L Bernard E. Billaud 5 F. Boue L Boyer A. Cabié 6 F. Caby 7 L. Cotte 8 P. de Truchis 9 X. Duval C. Duvivier 10 P Enel H. Fischer J. Gasnault 11 C Gaud C. Katlama 12 M Khuong O. Launay L Marchand S. Matheron 13 G Melica-Grégoire H Melliez J Meynard M. Nacher J. Pavie L. Piroth 14 I. Poizot-Martin 15 C. Pradier 16 J. Reynes 17 E Rouveix A Simon L Slama P. Tattevin 18 H. Tissot-Dupont 19, 20 G Astier T. Kurth N. Jacquemet S Abgrall S Grabar M. Guiguet S. Leclercq L Lièvre M Mary-Krause H Roul H Selinger-Leneman
Abstract : Abstract Objectives: We assessed virological outcomes of darunavir use in France from 2012 to 2016, in three groups of people living with HIV (PLHIV): (i) antiretroviral (ARV)-naive PLHIV; (ii) ARV-experienced PLHIV switching to darunavir while failing therapy; and (iii) ARV-experienced PLHIV switching to darunavir while virologically controlled. Methods: Virological success (VS) was defined as a plasma HIV-1 viral load (VL) <50 copies/mL and virological failure (VF) as two consecutive VL >50 copies/mL or one VL >50 copies/mL followed by a treatment switch prior to the next VL measurement. The cumulative incidence of VS was assessed considering darunavir discontinuation, loss to follow-up and death as competing risks, while estimates of cumulative incidence of VF accounted for loss to follow-up and death. Results: Among the 3235 ARV-naive PLHIV initiating darunavir, the 4 year cumulative incidence of VS was 80.9% and was associated with lower VL and higher CD4 cell counts. Among the 3485 ARV-experienced PLHIV switching to darunavir while failing therapy, the 4 year cumulative incidence of VS was 82.2% and was associated with lower VL. Among the 3005 ARV-experienced PLHIV switching to darunavir while virologically controlled, the 4 year cumulative incidence of VF was 12.6%. The risk of VF was higher with darunavir monotherapy [subdistribution hazard ratio (sHR)=1.67, 95% CI 1.15-2.42] while no difference was observed with dual therapy (sHR = 1.00, 95% CI 0.71-1.42) relative to triple therapy or more. Conclusions: Darunavir-containing regimens yielded similarly high rates of viral suppression in PLHIV whether they were ARV naive or ARV experienced switching to darunavir while failing therapy, or of maintaining VS in ARV-experienced PLHIV switching to darunavir while virologically controlled.
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Submitted on : Tuesday, January 21, 2020 - 3:24:34 PM
Last modification on : Wednesday, October 14, 2020 - 3:50:28 AM

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Valérie Potard, Ana Canestri, Sébastien Gallien, Dominique Costagliola, L Bernard, et al.. Use of darunavir in HIV-1-infected individuals in routine clinical practice from 2012 to 2016 in France. Journal of Antimicrobial Chemotherapy, Oxford University Press (OUP), 2019, 74 (11), pp.3305-3314. ⟨10.1093/jac/dkz338⟩. ⟨hal-02447354⟩

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