Determinants of sustained viral suppression in HIV-infected patients with self-reported poor adherence to antiretroviral therapy.

Determinants of sustained viral suppression in HIV-infected patients with self-reported poor adherence to antiretroviral therapy.

<h4>Background</h4>Good adherence to antiretroviral therapy (ART) is critical for successful HIV treatment. However, some patients remain virologically suppressed despite suboptimal adherence. We hypothesized that this could result from host genetic factors influencing drug levels.<h4...

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Autores principales: Tracy R Glass, Margalida Rotger, Amalio Telenti, Laurent Decosterd, Chantal Csajka, Heiner C Bucher, Huldrych F Günthard, Martin Rickenbach, Dunja Nicca, Bernard Hirschel, Enos Bernasconi, Gilles Wandeler, Manuel Battegay, Catia Marzolini, Swiss HIV Cohort Study
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Publicado: Public Library of Science (PLoS) 2012
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spelling oai:doaj.org-article:e7c083a016aa471fa1e1875c149442862021-11-18T07:31:13ZDeterminants of sustained viral suppression in HIV-infected patients with self-reported poor adherence to antiretroviral therapy.1932-620310.1371/journal.pone.0029186https://doaj.org/article/e7c083a016aa471fa1e1875c149442862012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22235271/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Good adherence to antiretroviral therapy (ART) is critical for successful HIV treatment. However, some patients remain virologically suppressed despite suboptimal adherence. We hypothesized that this could result from host genetic factors influencing drug levels.<h4>Methods</h4>Eligible individuals were Caucasians treated with efavirenz (EFV) and/or boosted lopinavir (LPV/r) with self-reported poor adherence, defined as missing doses of ART at least weekly for more than 6 months. Participants were genotyped for single nucleotide polymorphisms (SNPs) in candidate genes previously reported to decrease EFV (rs3745274, rs35303484, rs35979566 in CYP2B6) and LPV/r clearance (rs4149056 in SLCO1B1, rs6945984 in CYP3A, rs717620 in ABCC2). Viral suppression was defined as having HIV-1 RNA <400 copies/ml throughout the study period.<h4>Results</h4>From January 2003 until May 2009, 37 individuals on EFV (28 suppressed and 9 not suppressed) and 69 on LPV/r (38 suppressed and 31 not suppressed) were eligible. The poor adherence period was a median of 32 weeks with 18.9% of EFV and 20.3% of LPV/r patients reporting missed doses on a daily basis. The tested SNPs were not determinant for viral suppression. Reporting missing >1 dose/week was associated with a lower probability of viral suppression compared to missing 1 dose/week (EFV: odds ratio (OR) 0.11, 95% confidence interval (CI): 0.01-0.99; LPV/r: OR 0.29, 95% CI: 0.09-0.94). In both groups, the probability of remaining suppressed increased with the duration of continuous suppression prior to the poor adherence period (EFV: OR 3.40, 95% CI: 0.62-18.75; LPV/r: OR 5.65, 95% CI: 1.82-17.56).<h4>Conclusions</h4>The investigated genetic variants did not play a significant role in the sustained viral suppression of individuals with suboptimal adherence. Risk of failure decreased with longer duration of viral suppression in this population.Tracy R GlassMargalida RotgerAmalio TelentiLaurent DecosterdChantal CsajkaHeiner C BucherHuldrych F GünthardMartin RickenbachDunja NiccaBernard HirschelEnos BernasconiGilles WandelerManuel BattegayCatia MarzoliniSwiss HIV Cohort StudyPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 1, p e29186 (2012)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Tracy R Glass
Margalida Rotger
Amalio Telenti
Laurent Decosterd
Chantal Csajka
Heiner C Bucher
Huldrych F Günthard
Martin Rickenbach
Dunja Nicca
Bernard Hirschel
Enos Bernasconi
Gilles Wandeler
Manuel Battegay
Catia Marzolini
Swiss HIV Cohort Study
Determinants of sustained viral suppression in HIV-infected patients with self-reported poor adherence to antiretroviral therapy.
description <h4>Background</h4>Good adherence to antiretroviral therapy (ART) is critical for successful HIV treatment. However, some patients remain virologically suppressed despite suboptimal adherence. We hypothesized that this could result from host genetic factors influencing drug levels.<h4>Methods</h4>Eligible individuals were Caucasians treated with efavirenz (EFV) and/or boosted lopinavir (LPV/r) with self-reported poor adherence, defined as missing doses of ART at least weekly for more than 6 months. Participants were genotyped for single nucleotide polymorphisms (SNPs) in candidate genes previously reported to decrease EFV (rs3745274, rs35303484, rs35979566 in CYP2B6) and LPV/r clearance (rs4149056 in SLCO1B1, rs6945984 in CYP3A, rs717620 in ABCC2). Viral suppression was defined as having HIV-1 RNA <400 copies/ml throughout the study period.<h4>Results</h4>From January 2003 until May 2009, 37 individuals on EFV (28 suppressed and 9 not suppressed) and 69 on LPV/r (38 suppressed and 31 not suppressed) were eligible. The poor adherence period was a median of 32 weeks with 18.9% of EFV and 20.3% of LPV/r patients reporting missed doses on a daily basis. The tested SNPs were not determinant for viral suppression. Reporting missing >1 dose/week was associated with a lower probability of viral suppression compared to missing 1 dose/week (EFV: odds ratio (OR) 0.11, 95% confidence interval (CI): 0.01-0.99; LPV/r: OR 0.29, 95% CI: 0.09-0.94). In both groups, the probability of remaining suppressed increased with the duration of continuous suppression prior to the poor adherence period (EFV: OR 3.40, 95% CI: 0.62-18.75; LPV/r: OR 5.65, 95% CI: 1.82-17.56).<h4>Conclusions</h4>The investigated genetic variants did not play a significant role in the sustained viral suppression of individuals with suboptimal adherence. Risk of failure decreased with longer duration of viral suppression in this population.
format article
author Tracy R Glass
Margalida Rotger
Amalio Telenti
Laurent Decosterd
Chantal Csajka
Heiner C Bucher
Huldrych F Günthard
Martin Rickenbach
Dunja Nicca
Bernard Hirschel
Enos Bernasconi
Gilles Wandeler
Manuel Battegay
Catia Marzolini
Swiss HIV Cohort Study
author_facet Tracy R Glass
Margalida Rotger
Amalio Telenti
Laurent Decosterd
Chantal Csajka
Heiner C Bucher
Huldrych F Günthard
Martin Rickenbach
Dunja Nicca
Bernard Hirschel
Enos Bernasconi
Gilles Wandeler
Manuel Battegay
Catia Marzolini
Swiss HIV Cohort Study
author_sort Tracy R Glass
title Determinants of sustained viral suppression in HIV-infected patients with self-reported poor adherence to antiretroviral therapy.
title_short Determinants of sustained viral suppression in HIV-infected patients with self-reported poor adherence to antiretroviral therapy.
title_full Determinants of sustained viral suppression in HIV-infected patients with self-reported poor adherence to antiretroviral therapy.
title_fullStr Determinants of sustained viral suppression in HIV-infected patients with self-reported poor adherence to antiretroviral therapy.
title_full_unstemmed Determinants of sustained viral suppression in HIV-infected patients with self-reported poor adherence to antiretroviral therapy.
title_sort determinants of sustained viral suppression in hiv-infected patients with self-reported poor adherence to antiretroviral therapy.
publisher Public Library of Science (PLoS)
publishDate 2012
url https://doaj.org/article/e7c083a016aa471fa1e1875c14944286
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