Similar evolution of cellular HIV-1 DNA level in darunavir/ritonavir monotherapy versus triple therapy in MONOI-ANRS136 trial over 96 weeks

Sidonie Lambert-Niclot, Philippe Flandre, Marc-Antoine Valantin, Cathia Soulie, Slim Fourati, Marc Wirden, Sophie Sayon, Sophie Pakianather, Laurence Bocket, Bernard Masquelier, Georges Dos Santos, Christine Katlama, Vincent Calvez, Anne-Genevieve Marcelin, Sidonie Lambert-Niclot, Philippe Flandre, Marc-Antoine Valantin, Cathia Soulie, Slim Fourati, Marc Wirden, Sophie Sayon, Sophie Pakianather, Laurence Bocket, Bernard Masquelier, Georges Dos Santos, Christine Katlama, Vincent Calvez, Anne-Genevieve Marcelin

Abstract

Background: A higher proportion of intermittent viremia (to have a HIV-1 RNA viral load>50 copies/mL not confirmed) was reported in the boosted protease inhibitor monotherapy arm in some studies including MONOI trial, and that could have an impact on the replenishment of the HIV-1 DNA reservoirs. The HIV-1 DNA level is an interesting marker which reflects the size of cellular HIV reservoir. Our objectives were to study the impact of 96 weeks of Darunavir/ritonavir monotherapy versus a triple standard combination on the HIV-1 blood reservoir and factors associated with HIV-1 plasma DNA at baseline in MONOI trial sub-study.

Methodology/principal findings: This sub-study is focused on 160 patients (79 patients in monotherapy arm and 81 in tritherapy arm) for whom blood cells were available both at baseline and at week 96 (W96). Baseline HIV-1 plasma DNA was associated with CD4 nadir, pre therapeutic HIV-1 RNA viral load and baseline HIV-1 RNA measured by ultrasensitive assay. A similar median delta HIV-DNA was observed between D0 and W96 in both arms; 0.35 log copies/10(6) leucocytes in monotherapy arm versus 0.51 log copies/10(6) leucocytes in tritherapy arm.

Conclusion/significance: Despite a higher proportion of intermittent viremia in monotherapy arm, a similar evolution of cellular HIV-1 DNA level was observed between mono and triple therapy arm.

Trial registration: ClinicalTrials. gov NCT00421551.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Flow chart.
Figure 1. Flow chart.
Figure 2. Factors associated with log 10…
Figure 2. Factors associated with log10 HIV-DNA at baseline.
A. pre therapeutic VL (Pearson test); B. CD4 nadir (Spearman test); C. baseline HIV-1 RNA measured by ultrasensitive assay (Kruskal Wallis test).

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