@article{Lee:2024:10.1002/jia2.26349,
author = {Lee, MJ and Eason, M and Castagna, A and Laura, G and De, Scheerder M-A and Riley, J and Tebas, P and Gunst, J and Søgaard, O and Florence, E and Kroon, E and De, Souza M and Mothe, B and Caskey, M and Fidler, S},
doi = {10.1002/jia2.26349},
journal = {J Int AIDS Soc},
title = {The impact of analytical treatment interruptions and trial interventions on time to viral re-suppression in people living with HIV restarting ART in cure-related clinical studies: a systematic review and meta-analysis.},
url = {http://dx.doi.org/10.1002/jia2.26349},
volume = {27},
year = {2024}
}

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TY  - JOUR
AB  - INTRODUCTION: To assess the effectiveness of novel HIV curative strategies, "cure" trials require periods of closely monitored antiretroviral therapy (ART) analytical treatment interruptions (ATIs). We performed a systematic review and meta-analysis to identify the impact of ATI with or without novel therapeutics in cure-related studies on the time to viral re-suppression following ART restart. METHODS: Medline, Embase and Web of Science databases were searched for human studies involving ATIs from 1 January 2015 till 22 April 2024. The primary outcome was time to first viral re-suppression (plasma HIV viral load [VL] <50 copies/ml) stratified by receipt of interventional drug with ATI (IA) or ATI-only groups. Random-effects proportional meta-analysis and multivariable Cox proportional hazards analysis were performed using R. RESULTS: Of 1073 studies screened, 13 were included that met the inclusion criteria with VL data available after restarting ART (n = 213 participants). There was no difference between time to viral suppression in IA or ATI-only cohorts (p = 0.22). For 87% of participants, viral suppression within 12 weeks of ART restart was achieved, and all eventually had at least one VL <50 copies/ml during follow-up. After adjusting for covariables, while participants in the IA cohort were associated with less rapid suppression (adjusted hazard ratio [aHR] 0.61, 95% CI 0.40-0.94, p = 0.026), other factors include greater log VL at ART restart (aHR 0.56, 95% CI 0.46-0.68, p<0.001), duration since HIV diagnosis (aHR 0.93, 95% CI 0.89-0.96) and longer intervals between HIV VL monitoring (aHR 0.66, 95% CI 0.59-0.74, p<0.001). However, the use of integrase inhibitors was associated with more rapid viral suppression (aHR 1.74, 95% CI 1.16-2.59). DISCUSSION: When designing studies involving ATIs, information on time to viral re-suppression after restarting ART is important to share with participants, and should be regularly monitored and repor
AU  - Lee,MJ
AU  - Eason,M
AU  - Castagna,A
AU  - Laura,G
AU  - De,Scheerder M-A
AU  - Riley,J
AU  - Tebas,P
AU  - Gunst,J
AU  - Søgaard,O
AU  - Florence,E
AU  - Kroon,E
AU  - De,Souza M
AU  - Mothe,B
AU  - Caskey,M
AU  - Fidler,S
DO  - 10.1002/jia2.26349
PY  - 2024///
TI  - The impact of analytical treatment interruptions and trial interventions on time to viral re-suppression in people living with HIV restarting ART in cure-related clinical studies: a systematic review and meta-analysis.
T2  - J Int AIDS Soc
UR  - http://dx.doi.org/10.1002/jia2.26349
UR  - https://www.ncbi.nlm.nih.gov/pubmed/39155436
VL  - 27
ER  - 

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