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Switch to raltegravir-based regimens and HIV DNA decrease in patients with suppressed HIV RNA.
Claudia Bianco1, Genny Meini2, Barbara Rossetti1
1Infectious Diseases Unit, Azienda Ospedaliera Universitaria Senese, Siena, Italy.
Journal of the International AIDS Society
|November 15, 2014
Summary
Switching to raltegravir-based regimens may reduce the HIV reservoir, indicated by lower levels of HIV DNA in PBMCs. Further research with larger patient groups is needed to confirm this finding for HIV treatment.
Area of Science:
- Virology
- Immunology
- Pharmacology
Background:
- Raltegravir intensification in ART can increase 2-LTR episomal HIV DNA circles, suggesting persistent low-level replication in some patients.
- Monitoring residual plasma HIV RNA and cellular HIV DNA is crucial in virologically suppressed patients switching to raltegravir-based regimens.
Purpose of the Study:
- To monitor residual plasma HIV RNA and cellular HIV DNA in virologically suppressed HIV patients switching to a raltegravir-based regimen.
- To investigate the impact of switching to raltegravir on the HIV reservoir size.
Main Methods:
- Forty-six HIV-infected subjects on suppressed regimens were enrolled.
- 34 patients switched to raltegravir (RASTA group), 12 continued current regimens (control).
- Ultrasensitive HIV RNA and total PBMC HIV DNA were assessed at baseline, 24, and 48 weeks.
Main Results:
- HIV DNA was detectable in 82.3% of the RASTA group vs. 100% of controls at 48 weeks (p=0.01).
- A statistically significant decrease in HIV DNA was observed in the RASTA group from baseline to 48 weeks (p=0.035).
- No significant differences in HIV RNA levels were found within or between groups over time.
Conclusions:
- Switching to raltegravir-based regimens may be associated with a decrease in the HIV reservoir, as measured by total PBMC HIV DNA.
- Larger sample sizes are required to confirm this potential finding regarding HIV DNA reduction.
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