Higher efficacy of nevirapine than efavirenz to achieve HIV-1 plasma viral load below 1 copy/ml

• Published in: AIDS (London) Vol. 25; no. 3; pp. 341 - 344
• Main Authors: HAIM-BOUKOBZA, Stephanie, MORAND-JOUBERT, Laurence, CALVEZ, Vincent, MARCELIN, Anne-Geneviève, FLANDRE, Philippe, VALIN, Nadia, FOURATI, Slim, SAYON, Sophie, LAVIGNON, Marc, SIMON, Anne, GIRARD, Pierre-Marie, KATLAMA, Christine
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 28.01.2011
• Subjects: Adult; AIDS/HIV; Anti-HIV Agents - administration & dosage; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiretroviral Therapy, Highly Active; Antiviral agents; Benzoxazines - administration & dosage; Biological and medical sciences; Female; HIV Infections - drug therapy; HIV Infections - immunology; HIV Infections - virology; HIV-1 - drug effects; Human immunodeficiency virus 1; Human viral diseases; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infectious diseases; Male; Medical sciences; Middle Aged; Nevirapine - administration & dosage; Pharmacology. Drug treatments; Retrospective Studies; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Viral Load; Viremia; HIV-1; Antiretroviral agent; Benzoxazine derivatives; RNA-directed DNA polymerase; Acetylenic compound; Nevirapine; RNA; HIV-1 virus; Viremia; Non nucleoside compound; Efavirenz; Blood plasma; Microbiological investigation; Reverse transcriptase inhibitor; ultrasensitive quantification assay; Antiviral; Viral load; Quantitative analysis; Immunopathology; Enzyme; Transferases; Enzyme inhibitor; Retroviridae; AIDS; Immune deficiency; Lentivirus; residual viremia; Infection; Virus; Allosteric inhibitor; Nucleotidyltransferases; Viral disease; plasma HIV-1 RNA; Human immunodeficiency virus; non-nucleoside reverse transcriptase inhibitor
• ISSN: 0269-9370; 1473-5571
• DOI: 10.1097/QAD.0b013e3283427de3

To compare the level of HIV-1 residual viremia, defined by a viral load below 50 copies/ml in patients receiving a tenofovir/emtricitabine and nevirapine (NVP) or efavirenz (EFV)-containing regimen. One hundred and sixty-five HIV-1-infected patients were retrospectively included since they achieved virological suppression (viral load <50 copies/ml) for at least 6 months with a tenofovir/emtricitabine and non-nucleoside reverse transcriptase inhibitor-containing regimen (NVP, n = 75 and EFV, n = 90). Residual plasma viremia was measured using an ultrasensitive assay with a limit of quantification of 1 copy/ml. A Fisher's exact test was used to compare the percentage of patients with HIV-1 RNA below 1 copy/ml between the two treatment groups. Logistic regression was used to search for factors associated with a viral load below 1 copy/ml among the different patient characteristics. Patients in the NVP group had more frequently a viral load below 1 copy/ml than patients in the EFV group (81.3 vs. 55.6%, P < 0.001). In multivariate analysis, only NVP vs EFV (P = 0.005) and duration of viral suppression under antiretroviral treatment (P = 0.005) were independently associated with viral load below 1 copy/ml. It is well known that NVP has a good penetration in anatomic compartments that could explain a deep control of virus replication in some compartments and consequently decrease the residual level of viral load. The clinical relevance of having a viral load below 1 copy/ml has now to be studied for example on systemic inflammatory or immune activation markers.