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Resistance detected in PBMCs predicts virological rebound in HIV-1 suppressed patients switching treatment.
J Clin Virol. 2018 07; 104:61-64.JC

Abstract

BACKGROUND

Genotypic resistance test (GRT) performed in peripheral blood mononuclear cells (PBMC) represents a chance to evaluate resistance in virologically suppressed HIV infected patients.

OBJECTIVES

To evaluate the impact of baseline resistance detected through PBMC GRT on virological rebound after switching treatment.

STUDY DESIGN

Baseline genotypic susceptibility scores (GSS) from PBMC GRT (DNA-GSS) and from previous cumulative plasma GRTs (when available, pRNA-GSS) were evaluated. Survival analysis was used to assess the probability and predictors of virological rebound (VR).

RESULTS

227 virologically suppressed patients were analysed. Twenty-four months after switching therapy, the probability of VR was 15.3%. Patients showing an intermediate or full resistant DNA-GSS had a higher probability of experiencing VR compared to those carrying a fully susceptible DNA-GSS (27.2% vs. 13.7%, p = 0.001). By multivariable Cox regression, patients with an intermediate/full resistant DNA-GSS, with a nadir CD4 count <100 cell/mm3 and with a shorter time of previous virological suppression showed a higher adjusted hazard of experiencing VR. In a sub-group of 114 patients with previous plasma GRTs available, patients with an intermediate or fully resistance showed by both GSSs (from plasma and PBMCs) had the highest probability of experiencing VR.

CONCLUSIONS

Resistance detected in proviral DNA, together with a low nadir CD4 count and a short previous virological control, predicts VR after therapy switching in virologically suppressed patients. PBMC GRT can be a useful tool for tailoring treatment switch, especially if paired with information about previous cumulative resistance and previous viro-immunological history.

Authors+Show Affiliations

University of Rome "Tor Vergata", Rome, Italy.National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy. Electronic address: mauro.zaccarelli@inmi.it.Polyclinic of Modena, Modena, Italy.Polyclinic of Modena, Modena, Italy.University of Rome "Tor Vergata", Rome, Italy.National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy.National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy.University of Rome "Tor Vergata", Rome, Italy.National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy.University of Rome "Tor Vergata", Rome, Italy.National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy.La Sapienza University Polo Pontino, Latina, Italy.San Gallicano Dermatological Institute, IRCCS, Rome, Italy.University of Rome "Tor Vergata", Rome, Italy.La Sapienza University Polo Pontino, Latina, Italy.Polyclinic of Modena, Modena, Italy.National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy.National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy.University of Rome "Tor Vergata", Rome, Italy.

Pub Type(s)

Journal Article
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29738896

Citation

Armenia, Daniele, et al. "Resistance Detected in PBMCs Predicts Virological Rebound in HIV-1 Suppressed Patients Switching Treatment." Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology, vol. 104, 2018, pp. 61-64.
Armenia D, Zaccarelli M, Borghi V, et al. Resistance detected in PBMCs predicts virological rebound in HIV-1 suppressed patients switching treatment. J Clin Virol. 2018;104:61-64.
Armenia, D., Zaccarelli, M., Borghi, V., Gennari, W., Di Carlo, D., Giannetti, A., Forbici, F., Bertoli, A., Gori, C., Fabeni, L., Pinnetti, C., Marocco, R., Latini, A., Ceccherini-Silberstein, F., Mastroianni, C. M., Mussini, C., Antinori, A., Perno, C. F., & Santoro, M. M. (2018). Resistance detected in PBMCs predicts virological rebound in HIV-1 suppressed patients switching treatment. Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology, 104, 61-64. https://doi.org/10.1016/j.jcv.2018.04.001
Armenia D, et al. Resistance Detected in PBMCs Predicts Virological Rebound in HIV-1 Suppressed Patients Switching Treatment. J Clin Virol. 2018;104:61-64. PubMed PMID: 29738896.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Resistance detected in PBMCs predicts virological rebound in HIV-1 suppressed patients switching treatment. AU - Armenia,Daniele, AU - Zaccarelli,Mauro, AU - Borghi,Vanni, AU - Gennari,William, AU - Di Carlo,Domenico, AU - Giannetti,Alberto, AU - Forbici,Federica, AU - Bertoli,Ada, AU - Gori,Caterina, AU - Fabeni,Lavinia, AU - Pinnetti,Carmela, AU - Marocco,Raffaella, AU - Latini,Alessandra, AU - Ceccherini-Silberstein,Francesca, AU - Mastroianni,Claudio Maria, AU - Mussini,Cristina, AU - Antinori,Andrea, AU - Perno,Carlo Federico, AU - Santoro,Maria Mercedes, Y1 - 2018/04/03/ PY - 2017/11/05/received PY - 2018/04/02/accepted PY - 2018/5/9/pubmed PY - 2019/3/19/medline PY - 2018/5/9/entrez KW - Genotypic resistance test KW - HIV infection KW - HIV-DNA KW - PBMC KW - Treatment switch KW - Virological rebound KW - Virologically suppressed patients SP - 61 EP - 64 JF - Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology JO - J. Clin. Virol. VL - 104 N2 - BACKGROUND: Genotypic resistance test (GRT) performed in peripheral blood mononuclear cells (PBMC) represents a chance to evaluate resistance in virologically suppressed HIV infected patients. OBJECTIVES: To evaluate the impact of baseline resistance detected through PBMC GRT on virological rebound after switching treatment. STUDY DESIGN: Baseline genotypic susceptibility scores (GSS) from PBMC GRT (DNA-GSS) and from previous cumulative plasma GRTs (when available, pRNA-GSS) were evaluated. Survival analysis was used to assess the probability and predictors of virological rebound (VR). RESULTS: 227 virologically suppressed patients were analysed. Twenty-four months after switching therapy, the probability of VR was 15.3%. Patients showing an intermediate or full resistant DNA-GSS had a higher probability of experiencing VR compared to those carrying a fully susceptible DNA-GSS (27.2% vs. 13.7%, p = 0.001). By multivariable Cox regression, patients with an intermediate/full resistant DNA-GSS, with a nadir CD4 count <100 cell/mm3 and with a shorter time of previous virological suppression showed a higher adjusted hazard of experiencing VR. In a sub-group of 114 patients with previous plasma GRTs available, patients with an intermediate or fully resistance showed by both GSSs (from plasma and PBMCs) had the highest probability of experiencing VR. CONCLUSIONS: Resistance detected in proviral DNA, together with a low nadir CD4 count and a short previous virological control, predicts VR after therapy switching in virologically suppressed patients. PBMC GRT can be a useful tool for tailoring treatment switch, especially if paired with information about previous cumulative resistance and previous viro-immunological history. SN - 1873-5967 UR - https://www.unboundmedicine.com/medline/citation/29738896/Resistance_detected_in_PBMCs_predicts_virological_rebound_in_HIV_1_suppressed_patients_switching_treatment_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1386-6532(18)30092-1 DB - PRIME DP - Unbound Medicine ER -