title: Long-term HIV-1 virologic control in patients on a dual NRTI regimen.
abstract: BACKGROUND
  Since the release of protease inhibitors, only 2 randomized trials in the late 1990s have re-assessed the potency of dual nucleoside reverse transcriptase inhibitor (NRTI) combination (2N) as a maintenance strategy for patients whose HIV RNA was suppressed by tri-therapy. The objective of this study was to describe the characteristics of patients who exhibited durable virologic suppression while receiving 2N.
  
  
  METHODS
  A retrospective study was conducted in 2 French hospitals. Using electronic medical records, we identified all HIV-1-infected patients treated with tenofovir/emtricitabine or abacavir/lamivudine (without a third agent) between 2005 and 2012.
  
  
  RESULTS
  Out of 1,255 patients, 37 (3%) received a 2N regimen and were included in this study. All received a fixed-dose combination of either tenofovir/emtricitabine (n = 31) or abacavir/lamivudine (n = 6). This regimen was a first-line (n = 8) or a simplification (n = 29) strategy. The total follow-up for patients receiving 2N was 123 patient-years (median, 3.2 years; interquartile range [IQR], 1.3-5.1). At the last visit, 33 of 37 patients were continuing with 2N and had HIV RNA <50 copies/mL (success rate of 89%, snapshot analysis). These patients had received early treatment (median CD4+ nadir, 340/mm3) and had a low HIV RNA zenith (median, 3.9 log/mL) and a low HIV DNA level (median, 2.5 log copies/106 peripheral blood mononuclear cells). Four patients, treated with tenofovir/emtricitabine in the simplify cation group, experienced viral failure.
  
  
  CONCLUSIONS
  These results suggest that, in selected patients, a 2N fixed-dose combination is able to maintain viral suppression durably. Such a simple strategy could reduce both the constraints and side effects experienced by patients and the costs for the community.
authors.affiliation: Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Régional, Orléans, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Prazuck
authors.forename: David
authors.initials: D
authors.lastname: Zucman
authors.forename: Véronique
authors.initials: V
authors.lastname: Avettand-Fènoël
authors.forename: Elodie
authors.initials: E
authors.lastname: Ducasse
authors.forename: Dominique
authors.initials: D
authors.lastname: Bornarel
authors.forename: Catherine
authors.initials: C
authors.lastname: Mille
authors.forename: Christine
authors.initials: C
authors.lastname: Rouzioux
authors.forename: Laurent
authors.initials: L
authors.lastname: Hocqueloux
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D015497:HIV-1 / Q000187:drug effects / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000032:analysis; D012189:Retrospective Studies
chemical_list: D019380:Anti-HIV Agents; D012367:RNA, Viral