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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 Jacques Gasnault 11 C Gaud C. Katlama 7 M Khuong O. Launay L Marchand S. Matheron 12 G Melica-Grégoire H Melliez J Meynard Mathieu Nacher J. Pavie L. Piroth 13 I. Poizot-Martin 14 C. Pradier 15 J. Reynes 16 E Rouveix A Simon L Slama Pierre Tattevin 17 H. Tissot-Dupont 18, 19 G Astier T. Kurth Nicolas Jacquemet S Abgrall S Grabar M. Guiguet S. Leclercq L Lièvre M Mary-Krause H Roul H Selinger-Leneman
1 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
2 SU - Sorbonne Université
3 Service des maladies infectieuses et tropicales [CHU Tenon]
4 Service de maladies infectieuses et tropicales [Saint-Louis]
5 CHU Nantes - Centre hospitalier universitaire de Nantes
6 CIC - Antilles Guyane - Centre d'Investigation Clinique Antilles-Guyane
7 Service de Maladies Infectieuses et Tropicales [CHU Pitié-Salpêtrière]
8 UNICANCER/CRCL - Centre de Recherche en Cancérologie de Lyon
9 Hôpital Raymond Poincaré [AP-HP]
10 Centre d'infectiologie Necker-Pasteur [CHU Necker]
11 AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre)
12 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
13 Département d'infectiologie (CHU de Dijon)
14 Hôpitaux Sud - Hôpital Sainte-Marguerite [CHU - APHM]
15 Public Health Department, Hôpital de l'Archet
16 GIS - Laboratoire de Géochimie Isotopique Environnementale (GIS) / Université de Nîmes
17 Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes]
18 MEPHI - Microbes évolution phylogénie et infections
19 IHU Marseille - Institut Hospitalier Universitaire Méditerranée Infection
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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https://hal-amu.archives-ouvertes.fr/hal-02447354
Contributor : Isabelle Combe Connect in order to contact the contributor
Submitted on : Tuesday, January 21, 2020 - 3:24:34 PM
Last modification on : Sunday, May 1, 2022 - 3:16:48 AM

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UNIV-AMU | UNIV-AG | CEREGE | UNIV-LYON1 | IPLESP | SORBONNE-UNIVERSITE | UNIV-PARIS7 | SU-MEDECINE | CRCL | CNRS | UDL | OSU-INSTITUT-PYTHEAS | USPC | UNIV-PARIS | MAITC | U835 | UR1-UFR-SVE | UR1-BIO-SA | PASTEUR

Citation

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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