Personalized Care for HIV Prevention, Treatment and Cure

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Methodology, Drug and Device Discovery".

Deadline for manuscript submissions: closed (5 July 2022) | Viewed by 28046

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Guest Editor
Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, 5252 boul de maisonneuve-Office 3C.25, Montreal, QC H4A 3S5, Canada
Interests: HIV infection; HIV management; HIV prevention; e-Health; patient-oriented research; patient-reported outcome measures

Special Issue Information

Dear Colleagues,

Globally, great strides have been made in HIV testing and treatment over the last 30 years, which has helped to transform HIV from a fatal disease into a chronic, manageable condition for many people. However, HIV infection continues to pose a critical risk to health in many countries. The management of HIV can benefit from more individualized care and newer treatment options. Personalized medicine (PM) has the potential to tailor prevention and care interventions to optimize safety, effectiveness and patient satisfaction. By tailoring interventions to patient needs and characteristics (e.g., lifestyle, environment, genetics), chronic disease management goals are achieved. Researchers are actively seeking new personalized approaches to prevent, treat, and ultimately cure HIV infection.

This Special Issue of the Journal of Personalized Medicine is focused on describing current personalized medicine approaches to HIV care. This encompasses efforts to deliver individualized care using modern technologies and innovative care models for HIV prevention, comorbidities (hepatitis C, cardiovascular, neurocognitive decline, etc.) and treatment so as to improve the length and quality of life of HIV/AIDS patients.

This Special Issue will bring together cutting-edge research across disciplines, including the basic sciences, clinical care and the behavioral and social sciences, in order to better understand and intervene to the benefit of people living with HIV.

The aim of this Special Issue is to collate evidence-based manuscripts on relevant topics in the field. Research articles, clinical studies, quantitative and qualitative analyses of pilot studies, meta-analyses, and reviews are all welcome.

Dr. Bertrand Lebouche
Guest Editor

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • HIV infection
  • HIV prevention
  • HIV care
  • HIV cure
  • Antiretroviral therapy

Published Papers (11 papers)

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15 pages, 811 KiB  
Article
Development of a Prototype for a Bilingual Patient-Reported Outcome Measure of the Important Health Aspects of Quality of Life in People Living with HIV: The Preference Based HIV Index (PB-HIV)
by Kedar K. V. Mate, Bertrand Lebouché, Marie-Josée Brouillette, Lesley K. Fellows and Nancy E. Mayo
J. Pers. Med. 2022, 12(12), 2080; https://doi.org/10.3390/jpm12122080 - 16 Dec 2022
Viewed by 1600
Abstract
(1) Background: The aim of this project was to develop a short, HIV-specific, health-related quality of life measure with a scoring system based on patient preferences for the different dimensions of the Preference-Based HIV Index (PB-HIV). (2) Methods: This study is a cross-sectional [...] Read more.
(1) Background: The aim of this project was to develop a short, HIV-specific, health-related quality of life measure with a scoring system based on patient preferences for the different dimensions of the Preference-Based HIV Index (PB-HIV). (2) Methods: This study is a cross-sectional analysis of data from the Canadian Positive Brain Health Now cohort (n = 854; mean age 53 years). Items from the standardized measures were mapped to the areas from the Patient-Generated Index and formed the domains. A Rasch analysis was used to identify the best performing item to represent each dimension. Each item was then regressed on self-rated health (scored 0 to 100) and the regression parameters were used as scaling weights to form an index score for the prototype measure. (3) Results: Seven independent dimensions with three declarative statements ordered as response options formed the PB-HIV Index (pain, fatigue, memory/concentration, sleep, physical appearance/body image, depression, motivation). Regression parameters from a multivariable model yielded a measure with a scoring range from 0 (worst health) to 100 (perfect health). (4) Conclusions: Preference-based measures are optimal, as the total score reflects gains in some dimensions balanced against losses in others. The PB-HIV Index is the first HIV-specific preference-based measure. Full article
(This article belongs to the Special Issue Personalized Care for HIV Prevention, Treatment and Cure)
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23 pages, 1224 KiB  
Article
Experiences of Migrant People Living with HIV in a Multidisciplinary HIV Care Setting with Rapid B/F/TAF Initiation and Cost-Covered Treatment: The ‘ASAP’ Study
by Anish K. Arora, Kim Engler, David Lessard, Nadine Kronfli, Adriana Rodriguez-Cruz, Edmundo Huerta, Benoit Lemire, Jean-Pierre Routy, René Wittmer, Joseph Cox, Alexandra de Pokomandy, Lina Del Balso, Marina Klein, Giada Sebastiani, Isabelle Vedel, Amélie Quesnel-Vallée, ASAP Migrant Advisory Committee and Bertrand Lebouché
J. Pers. Med. 2022, 12(9), 1497; https://doi.org/10.3390/jpm12091497 - 13 Sep 2022
Cited by 3 | Viewed by 3575
Abstract
This study aimed to explore the experiences of migrant people living with HIV (MLWH) enrolled in a Montreal-based multidisciplinary HIV care clinic with rapid antiretroviral treatment (ART) initiation and cost-covered ART. Between February 2020 and March 2022, 32 interviews were conducted with 16 [...] Read more.
This study aimed to explore the experiences of migrant people living with HIV (MLWH) enrolled in a Montreal-based multidisciplinary HIV care clinic with rapid antiretroviral treatment (ART) initiation and cost-covered ART. Between February 2020 and March 2022, 32 interviews were conducted with 16 MLWH at three time-points (16 after 1 week of ART initiation, 8 after 24 weeks, 8 after 48 weeks). Interviews were analyzed via the Framework Method. Thirty categories were identified, capturing experiences across the HIV care cascade. At diagnosis, most MLWH described “initially experiencing distress”. At linkage, almost all MLWH discussed “navigating the health system with difficulty”. At treatment initiation, almost all MLWH expressed “being satisfied with treatment”, particularly due to a lack of side effects. Regarding care retention, all MLWH noted “facing psychosocial or health-related challenges beyond HIV”. Regarding ART adherence, most MLWH expressed “being satisfied with treatment” with emphasis on their taking control of HIV. At viral suppression, MLWH mentioned “finding more peace of mind since becoming undetectable”. Regarding their perceived health-related quality of life, most MLWH indicated “being helped by a supportive social network”. Efficient, humanizing, and holistic approaches to care in a multidisciplinary setting, coupled with rapid and free ART initiation, seemed to help alleviate patients’ concerns, address their bio-psycho-social challenges, encourage their initial and sustained engagement with HIV care and treatment, and ultimately contribute to positive experiences. Full article
(This article belongs to the Special Issue Personalized Care for HIV Prevention, Treatment and Cure)
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9 pages, 635 KiB  
Article
Differences in Antiretroviral Adherence Behaviors, Treatment Success, and Eligibility for Long-Acting Injectable Treatment between Patients Who Acquired HIV in Childhood vs. Those Who Acquired It in Adolescence/Early Adulthood
by Anthony Marcellin, Valérie Martel-Laferrière, Anne-Geneviève Genest, Bertrand Lebouché and Suzanne Marcotte
J. Pers. Med. 2022, 12(9), 1390; https://doi.org/10.3390/jpm12091390 - 27 Aug 2022
Viewed by 1187
Abstract
This study investigates the impact of the age at which HIV was acquired on adherence. There was no difference in adherence between patients who acquired HIV in childhood vs. those who acquired it in adolescence/early adulthood (83% vs. 90%; p = 0.24), but [...] Read more.
This study investigates the impact of the age at which HIV was acquired on adherence. There was no difference in adherence between patients who acquired HIV in childhood vs. those who acquired it in adolescence/early adulthood (83% vs. 90%; p = 0.24), but achievement of virological/immunological efficacy (78.8% vs. 93.5%, p = 0.02) was less likely in patients who had acquired HIV in childhood. On the basis of resistance, patients who acquired HIV in adolescence/early adulthood tended to be more eligible for cabotegravir/rilpivirine treatment (90.3% vs. 80.3%; p = 0.11). Full article
(This article belongs to the Special Issue Personalized Care for HIV Prevention, Treatment and Cure)
16 pages, 778 KiB  
Article
Prevalence of Physical Health, Mental Health, and Disability Comorbidities among Women Living with HIV in Canada
by Emily Heer, Angela Kaida, Nadia O’Brien, Bluma Kleiner, Alie Pierre, Danielle Rouleau, Ann N. Burchell, Lashanda Skerritt, Karène Proulx-Boucher, Valerie Nicholson, Mona Loutfy and Alexandra de Pokomandy
J. Pers. Med. 2022, 12(8), 1294; https://doi.org/10.3390/jpm12081294 - 06 Aug 2022
Cited by 4 | Viewed by 2499
Abstract
Life expectancy for people living with HIV has increased, but management of HIV is now more complex due to comorbidities. This study aimed to measure the prevalence of comorbidities among women living with HIV in Canada. We conducted a cross-sectional analysis using data [...] Read more.
Life expectancy for people living with HIV has increased, but management of HIV is now more complex due to comorbidities. This study aimed to measure the prevalence of comorbidities among women living with HIV in Canada. We conducted a cross-sectional analysis using data from the 18-months survey (2014–2016) of the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS). Self-report of diagnosed conditions was used to measure lifetime prevalence of chronic physical conditions, current mental health conditions, and disabilities. We examined frequency of overlapping conditions and prevalence stratified by gender identity, ethnicity, and age. Among 1039 participants, 70.1% reported a physical health diagnosis, 57.4% reported a current mental health diagnosis, 19.9% reported a disability, and 47.1% reported both physical and mental health comorbidities. The most prevalent comorbidities were depression (32.3%), anxiety (29.5%), obesity (26.7%, defined as body mass index >30 kg/m2), asthma/chronic obstructive pulmonary disease (23.3%), sleep disorder (22.0%), drug addiction (21.9%), and arthritis/osteoarthritis (20.9%). These results highlight the complexity of HIV care and the important prevalence of comorbidities. Personalized health care that integrates care and prevention of all comorbidities with HIV, with attention to social determinants of health, is necessary to optimize health and well-being of women living with HIV. Full article
(This article belongs to the Special Issue Personalized Care for HIV Prevention, Treatment and Cure)
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17 pages, 1261 KiB  
Article
Factors and Priorities Influencing Satisfaction with Care among Women Living with HIV in Canada: A Fuzzy Cognitive Mapping Study
by Lashanda Skerritt, Angela Kaida, Édénia Savoie, Margarite Sánchez, Iván Sarmiento, Nadia O’Brien, Ann N. Burchell, Gillian Bartlett, Isabelle Boucoiran, Mary Kestler, Danielle Rouleau, Mona Loutfy and Alexandra de Pokomandy
J. Pers. Med. 2022, 12(7), 1079; https://doi.org/10.3390/jpm12071079 - 30 Jun 2022
Cited by 1 | Viewed by 1900
Abstract
Engagement along the HIV care cascade in Canada is lower among women compared to men. We used Fuzzy Cognitive Mapping (FCM), a participatory research method, to identify factors influencing satisfaction with HIV care, their causal pathways, and relative importance from the perspective of [...] Read more.
Engagement along the HIV care cascade in Canada is lower among women compared to men. We used Fuzzy Cognitive Mapping (FCM), a participatory research method, to identify factors influencing satisfaction with HIV care, their causal pathways, and relative importance from the perspective of women living with HIV. Building from a map of factors derived from a mixed-studies review of the literature, 23 women living with HIV in Canada elaborated ten categories influencing their satisfaction with HIV care. The most central and influential category was “feeling safe and supported by clinics and healthcare providers”, followed by “accessible and coordinated services” and “healthcare provider expertise”. Participants identified factors that captured gendered social and health considerations not previously specified in the literature. These categories included “healthcare that considers women’s unique care needs and social contexts”, “gynecologic and pregnancy care”, and “family and partners included in care.” The findings contribute to our understanding of how gender shapes care needs and priorities among women living with HIV. Full article
(This article belongs to the Special Issue Personalized Care for HIV Prevention, Treatment and Cure)
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18 pages, 2309 KiB  
Article
Patient and Physician Preferences for Regimen Attributes for the Treatment of HIV in the United States and Canada
by Heather Gelhorn, Cindy Garris, Erin Arthurs, Frank Spinelli, Katelyn Cutts, Gin Nie Chua, Hannah Collacott, Bertrand Lebouché, Erik Lowman, Howard Rice and Sebastian Heidenreich
J. Pers. Med. 2022, 12(3), 334; https://doi.org/10.3390/jpm12030334 - 23 Feb 2022
Cited by 1 | Viewed by 2744
Abstract
A long-acting injectable (LAI) antiretroviral therapy (ART) regimen is now available as a treatment option for virologically suppressed adults with HIV-1. This study assessed preference for a LAI regimen using an online survey of virally suppressed people living with HIV (PLWH) and physicians [...] Read more.
A long-acting injectable (LAI) antiretroviral therapy (ART) regimen is now available as a treatment option for virologically suppressed adults with HIV-1. This study assessed preference for a LAI regimen using an online survey of virally suppressed people living with HIV (PLWH) and physicians treating HIV in the US and Canada. Preference was elicited in a discrete choice experiment (DCE) with three choice options (switch to a LAI regimen, switch to another daily oral ART regimen, or stay on their current daily oral ART regimen) and four treatment attributes. A total of 553 PLWH and 450 physicians completed the survey. From the DCE results, 59% of PLWH were predicted to prefer a LAI over an alternative oral ART or staying on their current oral treatment, and 55–66% of physicians were predicted to recommend LAI for PLWH, depending on the treatment challenge scenario presented. PLWH indicated LAI would remove daily reminders of HIV (75%) and reduce feelings of being stigmatized (68%). A majority of PLWH and physicians preferred a LAI over oral ART to overcome treatment challenges such as daily pill burden and adherence. These benefits of LAI ART along with preferences of PLWH and physicians can help to inform ART choice. Full article
(This article belongs to the Special Issue Personalized Care for HIV Prevention, Treatment and Cure)
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14 pages, 309 KiB  
Article
Understanding the Risks and Benefits of a Patient Portal Configured for HIV Care: Patient and Healthcare Professional Perspectives
by Dominic Chu, David Lessard, Moustafa A. Laymouna, Kim Engler, Tibor Schuster, Yuanchao Ma, Nadine Kronfli, Jean-Pierre Routy, Tarek Hijal, Karine Lacombe, Nancy Sheehan, Hayette Rougier and Bertrand Lebouché
J. Pers. Med. 2022, 12(2), 314; https://doi.org/10.3390/jpm12020314 - 19 Feb 2022
Cited by 3 | Viewed by 3042
Abstract
Background: Like other chronic viral illnesses, HIV infection necessitates consistent self-management and adherence to care and treatment, which in turn relies on optimal collaboration between patients and healthcare professionals (HCPs), including physicians, nurses, pharmacists, and clinical care coordinators. By providing people living with [...] Read more.
Background: Like other chronic viral illnesses, HIV infection necessitates consistent self-management and adherence to care and treatment, which in turn relies on optimal collaboration between patients and healthcare professionals (HCPs), including physicians, nurses, pharmacists, and clinical care coordinators. By providing people living with HIV (PLHIV) with access to their personal health information, educational material, and a communication channel with HCPs, a tailored patient portal could support their engagement in care. Our team intends to implement a patient portal in HIV-specialized clinics in Canada and France. We sought to understand the perceived risks and benefits among PLHIV and HCPs of patient portal use in HIV clinical care. Methods: This qualitative study recruited PLHIV and HIV-specialized HCPs, through maximum variation sampling and purposeful sampling, respectively. Semi-structured focus group discussions (FGDs) were held separately with PLHIV and HCPs between August 2019 and January 2020. FGDs were recorded, transcribed, coded using NVivo 12 software, and analyzed using content analysis. Results: A total of twenty-eight PLHIV participated in four FGDs, and thirty-one HCPs participated in six FGDs. PLHIV included eighteen men, nine women, and one person identifying as other; while, HCPs included ten men, twenty women, and one person identifying as other. A multi-disciplinary team of HCPs were included, involving physicians, nurses, pharmacists, social workers, and clinical coordinators. Participants identified five potential risks: (1) breach of confidentiality, (2) stress or uncertainty, (3) contribution to the digital divide, (4) dehumanization of care, and (5) increase in HCPs’ workload. They also highlighted four main benefits of using a patient portal: (1) improvement in HIV self-management, (2) facilitation of patient visits, (3) responsiveness to patient preferences, and (4) fulfillment of current or evolving patient needs. Conclusion: PLHIV and HCPs identified both risks and benefits of using a patient portal in HIV care. By engaging stakeholders and understanding their perspectives, the configuration of a patient portal can be optimized for end-users and concerns may be mitigated during its implementation. Full article
(This article belongs to the Special Issue Personalized Care for HIV Prevention, Treatment and Cure)
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13 pages, 1328 KiB  
Article
Two-Tier Care Pathways for Liver Fibrosis Associated to Non-Alcoholic Fatty Liver Disease in HIV Mono-Infected Patients
by Giada Sebastiani, Jovana Milic, Adriana Cervo, Sahar Saeed, Thomas Krahn, Dana Kablawi, Al Shaima Al Hinai, Bertrand Lebouché, Philip Wong, Marc Deschenes, Claudia Gioè, Antonio Cascio, Giovanni Mazzola and Giovanni Guaraldi
J. Pers. Med. 2022, 12(2), 282; https://doi.org/10.3390/jpm12020282 - 15 Feb 2022
Cited by 2 | Viewed by 1963
Abstract
(1) Background: Developing strategies to identify significant liver fibrosis in people with HIV (PWH) is crucial to prevent complications of non-alcoholic fatty liver disease (NAFLD). We aim to investigate if five simple serum biomarkers applied to PWH can optimize a care pathway to [...] Read more.
(1) Background: Developing strategies to identify significant liver fibrosis in people with HIV (PWH) is crucial to prevent complications of non-alcoholic fatty liver disease (NAFLD). We aim to investigate if five simple serum biomarkers applied to PWH can optimize a care pathway to identify significant liver fibrosis defined by transient elastography (TE). (2) Methods: A two-tier fibrosis pathway was applied to three prospective cohorts of PWH undergoing TE with CAP. NAFLD was diagnosed as a controlled attenuation parameter ≥ 248 dB/m. Five simple fibrosis biomarkers (FIB-4 < 1.3, BARD score 0–1, NAFLD fibrosis score < −1.455, AST:ALT ratio < 0.8 and APRI < 0.5) were applied as first-tiers to exclude significant liver fibrosis. We determined the decrease in referral for TE that would have occurred based on biomarker assessment and the discordance between low simple fibrosis biomarkers and high TE (≥7.1 kPa), indicating significant liver fibrosis. (3) Results: Of the 1749 consecutive PWH, 15.1% had significant liver fibrosis by TE and 39.1% had NAFLD. The application of the fibrosis biomarkers as first tiers would have resulted in a decrease in TE referrals between 24.9% (BARD score) and 86.3% (APRI). The lowest discordance rate was with NAFLD fibrosis score (8.5%). After adjustments, BMI (odds ratio (OR) 1.12, 95% CI: 1.08–1.17) and triglycerides (OR 1.26, 95% CI: 1.11–1.44) were independent predictors of discordance for APRI < 0.5 and TE ≥ 7.1. The performance of the two-tier pathways was similar in PWH with and without NAFLD. (4) Conclusions: Implementing a two-tier pathway could save a substantial proportion up of TE examinations, reducing costs and helping resource optimization in HIV care. Patients with metabolic risk factors for NAFLD and low fibrosis biomarker may still be considered for TE referral. Full article
(This article belongs to the Special Issue Personalized Care for HIV Prevention, Treatment and Cure)
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21 pages, 3158 KiB  
Article
Preliminary Acceptability of a Home-Based Peripheral Blood Collection Device for Viral Load Testing in the Context of Analytical Treatment Interruptions in HIV Cure Trials: Results from a Nationwide Survey in the United States
by Karine Dubé, Shadi Eskaf, Elizabeth Hastie, Harsh Agarwal, Laney Henley, Christopher Roebuck, William B. Carter, Lynda Dee, Jeff Taylor, Derrick Mapp, Danielle M. Campbell, Thomas J. Villa, Beth Peterson, Kenneth M. Lynn, Linden Lalley-Chareczko, Emily Hiserodt, Sukyung Kim, Daniel Rosenbloom, Brad R. Evans, Melanie Anderson, Daria J. Hazuda, Lisa Shipley, Kevin Bateman, Bonnie J. Howell, Karam Mounzer, Pablo Tebas and Luis J. Montaneradd Show full author list remove Hide full author list
J. Pers. Med. 2022, 12(2), 231; https://doi.org/10.3390/jpm12020231 - 07 Feb 2022
Cited by 8 | Viewed by 3854
Abstract
Frequent viral load testing is necessary during analytical treatment interruptions (ATIs) in HIV cure-directed clinical trials, though such may be burdensome and inconvenient to trial participants. We implemented a national, cross-sectional survey in the United States to examine the acceptability of a novel [...] Read more.
Frequent viral load testing is necessary during analytical treatment interruptions (ATIs) in HIV cure-directed clinical trials, though such may be burdensome and inconvenient to trial participants. We implemented a national, cross-sectional survey in the United States to examine the acceptability of a novel home-based peripheral blood collection device for HIV viral load testing. Between June and August 2021, we distributed an online survey to people with HIV (PWH) and community members, biomedical HIV cure researchers and HIV care providers. We performed descriptive analyses to summarize the results. We received 73 survey responses, with 51 from community members, 12 from biomedical HIV cure researchers and 10 from HIV care providers. Of those, 51 (70%) were cisgender men and 50 (68%) reported living with HIV. Most (>80% overall) indicated that the device would be helpful during ATI trials and they would feel comfortable using it themselves or recommending it to their patients/participants. Of the 50 PWH, 42 (84%) indicated they would use the device if they were participating in an ATI trial and 27 (54%) also expressed a willingness to use the device outside of HIV cure studies. Increasing sensitivity of viral load tests and pluri-potency of the device (CD4 count, chemistries) would augment acceptability. Survey findings provide evidence that viral load home testing would be an important adjunct to ongoing HIV cure-directed trials involving ATIs. Survey findings may help inform successful implementation and uptake of the device in the context of personalized HIV care. Full article
(This article belongs to the Special Issue Personalized Care for HIV Prevention, Treatment and Cure)
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10 pages, 376 KiB  
Article
Could Long-Acting Cabotegravir-Rilpivirine Be the Future for All People Living with HIV? Response Based on Genotype Resistance Test from a Multicenter Italian Cohort
by Andrea De Vito, Annarita Botta, Marco Berruti, Valeria Castelli, Vincenzo Lai, Chiara Cassol, Alessandro Lanari, Giulia Stella, Adrian Shallvari, Antonia Bezenchek and Antonio Di Biagio
J. Pers. Med. 2022, 12(2), 188; https://doi.org/10.3390/jpm12020188 - 31 Jan 2022
Cited by 4 | Viewed by 2877
Abstract
Long-acting (LA) formulations have been designed to improve the quality of life of people with HIV (PWH) by maintaining virologic suppression. However, clinical trials have shown that patient selection is crucial. In fact, the HIV-1 resistance genotype test and the Body Mass Index [...] Read more.
Long-acting (LA) formulations have been designed to improve the quality of life of people with HIV (PWH) by maintaining virologic suppression. However, clinical trials have shown that patient selection is crucial. In fact, the HIV-1 resistance genotype test and the Body Mass Index of individual patients assume a predominant role in guiding the choice. Our work aimed to estimate the patients eligible for the new LA therapy with cabotegravir (CAB) + rilpivirine (RPV). We selected, from the Antiviral Response Cohort Analysis (ARCA) database, all PWH who had at least one follow-up in the last 24 months. We excluded patients with HBsAg positivity, evidence of non-nucleoside reverse transcriptase inhibitor (except K103N) and integrase inhibitor mutations, and with a detectable HIV-RNA (>50 copies/mL). Overall, 4103 patients are currently on follow-up in the ARCA, but the eligible patients totaled 1641 (39.9%). Among them, 1163 (70.9%) were males and 1399 were Caucasian (85.3%), of which 1291 (92%) were Italian born. The median length of HIV infection was 10.2 years (IQR 6.3–16.3) with a median nadir of CD4 cells/count of 238 (106–366) cells/mm3 and a median last available CD4 cells/count of 706 (509–944) cells/mm3. The majority of PWH were treated with a three-drug regimen (n = 1116, 68%). Among the 525 (30.3%) patients treated with two-drug regimens, 325 (18.1%) were treated with lamivudine (3TC) and dolutegravir (DTG) and only 84 (5.1%) with RPV and DTG. In conclusion, according to our snapshot, roughly 39.9% of virologically suppressed patients may be suitable candidates for long-acting CAB+RPV therapy. Therefore, based on our findings, many different variables should be taken into consideration to tailor the antiretroviral treatment according to different individual characteristics. Full article
(This article belongs to the Special Issue Personalized Care for HIV Prevention, Treatment and Cure)
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7 pages, 571 KiB  
Brief Report
Intermittent Bictegravir/Emtricitabine/Tenofovir Alafenamide Treatment Maintains High Level of Viral Suppression in Virally Suppressed People Living with HIV
by Baptiste Sellem, Basma Abdi, Minh Lê, Roland Tubiana, Marc-Antoine Valantin, Sophie Seang, Luminita Schneider, Antoine Fayçal, Gilles Peytavin, Cathia Soulié, Anne-Geneviève Marcelin, Christine Katlama, Valérie Pourcher and Romain Palich
J. Pers. Med. 2023, 13(4), 583; https://doi.org/10.3390/jpm13040583 - 27 Mar 2023
Cited by 4 | Viewed by 1582
Abstract
In this observational study, we aimed to evaluate whether bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) administered 5 or 4 days a week is able to maintain viral suppression in people living with HIV (PLHIV). We enrolled 85 patients who initiated intermittent B/F/TAF between 28 November 2018 [...] Read more.
In this observational study, we aimed to evaluate whether bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) administered 5 or 4 days a week is able to maintain viral suppression in people living with HIV (PLHIV). We enrolled 85 patients who initiated intermittent B/F/TAF between 28 November 2018 and 30 July 2020: median (IQR) age 52 years (46–59), duration of virological suppression 9 years (3–13), CD4 633/mm3 (461–781). Median follow-up was 101 weeks (82–111). The virological success rate (no virological failure [VF]: confirmed plasma viral load [pVL] ≥ 50 copies/mL, or single pVL ≥ 200 copies/mL, or ≥50 copies/mL with ART change) was 100% (95%CI 95.8–100) and the strategy success rate (pVL < 50 copies/mL with no ART regimen change) was 92.9% (95%CI 85.3–97.4) at W48. Two VF occurred at W49 and W70, in 2 patients self-reporting poor compliance. No resistance mutation emerged at time of VF. Eight patients presented strategy discontinuation for adverse events. There was no significant change in the CD4 count, residual viraemia rate, neither body weight during follow-up, but a slight increase in CD4/CD8 ratio (p = 0.02). In conclusion, our findings suggest that B/F/TAF administered 5 or 4 days a week could maintain the control of HIV replication in virologically suppressed PLHIV while reducing cumulative exposition of ART. Full article
(This article belongs to the Special Issue Personalized Care for HIV Prevention, Treatment and Cure)
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