title: Continuous versus intermittent treatment strategies during primary HIV-1 infection:  the randomized ANRS INTERPRIM Trial.
abstract: OBJECTIVE
  The ANRS-112 INTERPRIM trial assessed whether fixed-cycles of antiretroviral treatment interruption (ART-STI) combined or not with pegylated interferon alpha-2b (peg-IFN) could lower viral load and achieve a healthier immune system in patients diagnosed during primary HIV-1-infection (PHI).
  
  
  METHODS
  Patients were randomized to receive either continuous ART (cART) during 72 weeks, or cART during 36 weeks followed by three ART-STIs, or the same ART-STIs associated with peg-IFN during the first 14 weeks and each interruption (ART-STI-IFN). Treatment was stopped at week 72. Final evaluation was based on plasma HIV-RNA level 6 months after the last treatment interruption.
  
  
  RESULTS
  Eighty-seven percent of patients achieved undetectable HIV-RNA at week 32, with no deleterious impact of sequential treatment interruptions (STIs). Viral rebounds during interruptions were lower in the ART-STI-IFN than in the ART-STI group and during the second and third interruptions compared with the first one. However, HIV-RNA levels, CD4 T-cell counts and CD4 T/CD8 T ratios were similar between groups after the 6-month interruption, with a persistent effect on CD4 T cells and total cell-associated HIV-DNA levels. Predictive factors of virological outcome were HIV-RNA and HIV-DNA levels at PHI and HIV-DNA levels at treatment interruption. HIV-specific responses did not differ between strategies and were not associated with outcome. Forty-eight percent of patients experienced treatment resumption during long-term follow-up without difference between groups.
  
  
  CONCLUSIONS
  When initiated during PHI, STIs associated or not with IFN did not result in a different outcome as compared to cART. All regimens showed a high response rate and a sustained immunological benefit after cessation.
authors: Service de Médecine Interne, Hôpital Bicêtre, Assistance Publique - Hôpitaux de Paris (AP-HP), Le Kremlin Bicêtre, France. cecile.goujard@bct.aphp.fr
authors: Cécile
authors: C
authors: Goujard
authors: Dominique
authors: D
authors: Emilie
authors: Caroline
authors: C
authors: Roussillon
authors: Véronique
authors: V
authors: Godot
authors: Christine
authors: C
authors: Rouzioux
authors: Alain
authors: A
authors: Venet
authors: Céline
authors: C
authors: Colin
authors: Gilles
authors: G
authors: Pialoux
authors: Pierre-Marie
authors: PM
authors: Girard
authors: Valérie
authors: V
authors: Boilet
authors: Marie-Laure
authors: ML
authors: Chaix
authors: Pierre
authors: P
authors: Galanaud
authors: Geneviève
authors: G
authors: Chene
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000494:pharmacology; D016516:CD4-CD8 Ratio; D015496:CD4-Positive T-Lymphocytes / Q000187:drug effects*; D018414:CD8-Positive T-Lymphocytes / Q000187:drug effects*; D004279:DNA, Viral / Q000187:drug effects; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D015497:HIV-1 / Q000187:drug effects* / Q000276:immunology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage* / Q000494:pharmacology; D008213:Lymphocyte Activation / Q000187:drug effects* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage* / Q000494:pharmacology; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000494:pharmacology; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D004279:DNA, Viral; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; C417083:peginterferon alfa-2b