title: Evaluation of residual viremia and quantitation of soluble CD14 in a large cohort of HIV-infected adults on a long-term non-nucleoside reverse transcriptase inhibitor-based regimen.
abstract: Beyond virological suppression and immunologic recovery, the objective of long-term antiretroviral therapy is to suppress maximally viremia and to control for persistent immune activation. Non-nucleoside reverse transcriptase inhibitor (NNRTI)-containing regimens are associated with lower residual viremia. The objective of the study was to evaluate the impact of long term NNRTI-containing treatment on residual viremia and on monocyte activation in a cohort of patients infected with HIV-1. To identify factors associated with residual viremia, adult patients infected with HIV on nevirapine or efavirenz-based therapy with viral load <50 copies/ml for >6 months were included. Residual plasma viremia was quantified using an adapted Cobas/Taqman HIV-1 assay. Viral loads with no detected signal were considered as <1 copy/ml. Monocyte activation was evaluated by quantitation of plasma sCD14 by ELISA assay at the time of residual viremia measurement. Logistic regression was used to determine factors associated with residual viremia <1 copy/ml. In this cohort of 421 patients on long-term NNRTI regimen, three quarters had a residual viremia <1 copy/ml. In multivariate analysis, duration of plasma viral load below 50 copies/ml was the only factor associated with residual viremia <1 copy/ml. Soluble CD14 was in the normal range although treatment with nevirapine was associated with a significant lower level of sCD14 compared to efavirenz. Residual viremia <1 copy/ml was frequent in this cohort of patients with long term virological control and confirmed the results of previous studies. Apart from its antiviral effect, nevirapine as well as efavirenz could decrease monocyte activation.
authors.affiliation: Infectious Diseases, Hotel-Dieu University Hospital, Nantes, France. clotilde.allavena@chu-nantes.fr
authors.forename: Clotilde
authors.initials: C
authors.lastname: Allavena
authors.forename: Audrey
authors.initials: A
authors.lastname: Rodallec
authors.forename: Solène
authors.initials: S
authors.lastname: Sécher
authors.forename: Véronique
authors.initials: V
authors.lastname: Reliquet
authors.forename: Sandrine
authors.initials: S
authors.lastname: Baffoin
authors.forename: Elisabeth
authors.initials: E
authors.lastname: André-Garnier
authors.forename: Eric
authors.initials: E
authors.lastname: Billaud
authors.forename: François
authors.initials: F
authors.lastname: Raffi
authors.forename: Virginie
authors.initials: V
authors.lastname: Ferré
mesh_terms: D000328:Adult; D000480:Alkynes; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D048588:Benzoxazines / Q000627:therapeutic use; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003521:Cyclopropanes; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000821:virology*; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D018950:Lipopolysaccharide Receptors / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000276:immunology; D019829:Nevirapine / Q000627:therapeutic use; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D019562:Viral Load; D014766:Viremia
chemical_list: D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D003521:Cyclopropanes; D018950:Lipopolysaccharide Receptors; D018894:Reverse Transcriptase Inhibitors; D019829:Nevirapine; C098320:efavirenz
keywords: HIV infection; NNRTI; antiretroviral therapy; monocyte activation; residual viremia