Contribution of different antiretroviral regimens containing zidovudine, lamivudine and ritonavir-boosted lopinavir on HIV viral load reduction during pregnancy

© 2016 International Medical Press. Background: Antiretroviral (ARV) regimens used for the prevention of mother-to-child transmission of HIV have evolved over time. We evaluated the contribution of different ARV regimens on the reduction of the plasma HIV RNA viral load (VL) during pregnancy. Method...

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Main Authors: Sripan P., Le Coeur S., Ingsrisawang L., Cressey T., Bouazza N., Foissac F., Ngo-Giang-Huong N., Traisathit P., Srirompotong U., Ayudhaya O., Puangsombat A., Jungpipun J., Jittayanun K., Tréluyer J., Jourdain G., Lallemant M., Urien S.
Format: Journal
Published: 2017
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http://cmuir.cmu.ac.th/jspui/handle/6653943832/42661
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Institution: Chiang Mai University
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spelling th-cmuir.6653943832-426612017-09-28T04:28:20Z Contribution of different antiretroviral regimens containing zidovudine, lamivudine and ritonavir-boosted lopinavir on HIV viral load reduction during pregnancy Sripan P. Le Coeur S. Ingsrisawang L. Cressey T. Bouazza N. Foissac F. Ngo-Giang-Huong N. Traisathit P. Srirompotong U. Ayudhaya O. Puangsombat A. Jungpipun J. Jittayanun K. Tréluyer J. Jourdain G. Lallemant M. Urien S. © 2016 International Medical Press. Background: Antiretroviral (ARV) regimens used for the prevention of mother-to-child transmission of HIV have evolved over time. We evaluated the contribution of different ARV regimens on the reduction of the plasma HIV RNA viral load (VL) during pregnancy. Methods: A total of 1,833 VL measurements from ARVnaive pregnant women participating in perinatal prevention trials in Thailand were included. Women received either zidovudine (ZDV) monotherapy, ZDV plus lopinavir/ ritonavir (LPV/r), or ZDV plus lamivudine (3TC) plus LPV/r. VL time-course during pregnancy was described as a function of pretreatment VL and treatment duration using an Emax non-linear mixed-effect model. VL reduction and median time to achieve a VL < 50 copies/ml were estimated for each regimen. Results: Among 745 women, 279 (37%), 145 (20%) and 321 (43%) received ZDV monotherapy, ZDV+LPV/r and ZDV+3TC+LPV/r, respectively. The predicted VL reduction from baseline to delivery after a median of 10 weeks of treatment were 0.5, 2.7 and 2.9 log10 copies/ml with ZDV monotherapy, ZDV+LPV/r and ZDV+3TC+LPV/r, respectively. At delivery, 1%, 57% and 63% of women receiving ZDV monotherapy, ZDV+LPV/r or ZDV+3TC+LPV/r had a VL < 50 copies/ml. The addition of 3TC to ZDV+LPV/r reduced the time to achieve a VL < 50 copies/ml and the higher the pretreatment VL, the larger the effect 3TC had on reducing the time to VL < 50 copies/ml. Conclusions: The addition of 3TC to ZDV+LPV/r was associated with a slight further VL reduction but the time to reach a VL < 50 copies/ml was shorter. This beneicial effect of 3TC is crucial for prevention of motherto-child transmission in women who receive ARVs late and with high pretreatment VL. 2017-09-28T04:28:20Z 2017-09-28T04:28:20Z 2016-01-01 Journal 13596535 2-s2.0-84991493939 10.3851/IMP3001 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84991493939&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/42661
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
description © 2016 International Medical Press. Background: Antiretroviral (ARV) regimens used for the prevention of mother-to-child transmission of HIV have evolved over time. We evaluated the contribution of different ARV regimens on the reduction of the plasma HIV RNA viral load (VL) during pregnancy. Methods: A total of 1,833 VL measurements from ARVnaive pregnant women participating in perinatal prevention trials in Thailand were included. Women received either zidovudine (ZDV) monotherapy, ZDV plus lopinavir/ ritonavir (LPV/r), or ZDV plus lamivudine (3TC) plus LPV/r. VL time-course during pregnancy was described as a function of pretreatment VL and treatment duration using an Emax non-linear mixed-effect model. VL reduction and median time to achieve a VL < 50 copies/ml were estimated for each regimen. Results: Among 745 women, 279 (37%), 145 (20%) and 321 (43%) received ZDV monotherapy, ZDV+LPV/r and ZDV+3TC+LPV/r, respectively. The predicted VL reduction from baseline to delivery after a median of 10 weeks of treatment were 0.5, 2.7 and 2.9 log10 copies/ml with ZDV monotherapy, ZDV+LPV/r and ZDV+3TC+LPV/r, respectively. At delivery, 1%, 57% and 63% of women receiving ZDV monotherapy, ZDV+LPV/r or ZDV+3TC+LPV/r had a VL < 50 copies/ml. The addition of 3TC to ZDV+LPV/r reduced the time to achieve a VL < 50 copies/ml and the higher the pretreatment VL, the larger the effect 3TC had on reducing the time to VL < 50 copies/ml. Conclusions: The addition of 3TC to ZDV+LPV/r was associated with a slight further VL reduction but the time to reach a VL < 50 copies/ml was shorter. This beneicial effect of 3TC is crucial for prevention of motherto-child transmission in women who receive ARVs late and with high pretreatment VL.
format Journal
author Sripan P.
Le Coeur S.
Ingsrisawang L.
Cressey T.
Bouazza N.
Foissac F.
Ngo-Giang-Huong N.
Traisathit P.
Srirompotong U.
Ayudhaya O.
Puangsombat A.
Jungpipun J.
Jittayanun K.
Tréluyer J.
Jourdain G.
Lallemant M.
Urien S.
spellingShingle Sripan P.
Le Coeur S.
Ingsrisawang L.
Cressey T.
Bouazza N.
Foissac F.
Ngo-Giang-Huong N.
Traisathit P.
Srirompotong U.
Ayudhaya O.
Puangsombat A.
Jungpipun J.
Jittayanun K.
Tréluyer J.
Jourdain G.
Lallemant M.
Urien S.
Contribution of different antiretroviral regimens containing zidovudine, lamivudine and ritonavir-boosted lopinavir on HIV viral load reduction during pregnancy
author_facet Sripan P.
Le Coeur S.
Ingsrisawang L.
Cressey T.
Bouazza N.
Foissac F.
Ngo-Giang-Huong N.
Traisathit P.
Srirompotong U.
Ayudhaya O.
Puangsombat A.
Jungpipun J.
Jittayanun K.
Tréluyer J.
Jourdain G.
Lallemant M.
Urien S.
author_sort Sripan P.
title Contribution of different antiretroviral regimens containing zidovudine, lamivudine and ritonavir-boosted lopinavir on HIV viral load reduction during pregnancy
title_short Contribution of different antiretroviral regimens containing zidovudine, lamivudine and ritonavir-boosted lopinavir on HIV viral load reduction during pregnancy
title_full Contribution of different antiretroviral regimens containing zidovudine, lamivudine and ritonavir-boosted lopinavir on HIV viral load reduction during pregnancy
title_fullStr Contribution of different antiretroviral regimens containing zidovudine, lamivudine and ritonavir-boosted lopinavir on HIV viral load reduction during pregnancy
title_full_unstemmed Contribution of different antiretroviral regimens containing zidovudine, lamivudine and ritonavir-boosted lopinavir on HIV viral load reduction during pregnancy
title_sort contribution of different antiretroviral regimens containing zidovudine, lamivudine and ritonavir-boosted lopinavir on hiv viral load reduction during pregnancy
publishDate 2017
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84991493939&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/42661
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