Open AccessVirological outcome measures during analytical treatment interruptions in chronic HIV-1 infected patients
Author(s) -
Csaba Fehér,
Lorna Leal,
Montserrat Plana,
Núria Climent,
Alberto C. Guardo,
Estebán Martínez,
Pedro Castro,
Vicens Díaz-Brito,
Beatriz Mothe,
Juan Carlos Lopez Bernaldo de Quirós,
Josep M. Gatell,
Patrick Aloy,
Felipe García
Publication year - 2019
Publication title -
open forum infectious diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.546
H-Index - 35
ISSN - 2328-8957
DOI - 10.1093/ofid/ofz485
Subject(s) - medicine , confounding , surrogate endpoint , viral load , time point , clinical endpoint , human immunodeficiency virus (hiv) , clinical trial , immunology , philosophy , aesthetics
Background Analytical treatment interruptions (ATI) are essential in research on HIV cure. However, the heterogeneity of virological outcome measures used in different trials hinders the interpretation of the efficacy of different strategies. Methods A retrospective analysis of viral load (VL) evolution in 334 ATI episodes in chronic HIV-1 infected patients collected from 11 prospective studies. Quantitative [baseline VL, set point, delta set point, VL and delta VL at given weeks after ATI, peak VL, delta peak VL, and area under the rebound curve], and temporal parameters [time to rebound (TtR), set point, peak, and certain absolute and relative VL thresholds] were described. Pairwise correlations between parameters were analyzed, and potential confounding factors (sex, age, time of known HIV infection, time on ART, and immunological interventions) were evaluated. Results Set point was lower than baseline VL (median delta set point -0.26. p 1 log10 copies/mL in 13.9% of the cases. Median TtR was 2 weeks; no patients had undetectable VL at week 12. Median time to set point was 8 weeks: by week 12, 97.4% of the patients had reached the set point. TtR and baseline VL were correlated with most temporal and quantitative parameters. The variables independently associated with TtR were baseline VL and the use of immunological interventions. Conclusions TtR could be an optimal surrogate marker of response in HIV cure strategies. Our results underline the importance of taking into account baseline VL and other confounding factors in the design and interpretation of these studies.