7th IAS Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2013)


WEAB01 Reach for the Top: Can We Perfect Current ART?
  Oral Abstract Session : Track B Clinical Sciences
Venue: Session Room 1
Time: 03.07.2013, 11:00 - 12:30
Co-Chairs: Robert Murphy, United States
Sasisopin Kiertiburanakul, Thailand

11:00
WEAB0101
Abstract
Impact of 12 months HAART on cell-associated HIV-DNA in acute primary HIV-1 infection in the OPTIPRIM-ANRS 147 trial
A. Chéret1,2, G. Nembot3, V. Avettand-fenoël1,4, A. Mélard1,4, I. Ravaux5, B. Hoen6, C. Lascoux-Combe7, M.-L. Chaix4,8, C. Tamalet9, P. Yeni10, F. Raffi11, L. Slama12, C. Katlama13, A. Venet14, B. Autran15,16, A. Saez-Cirion17, L. Meyer3, C. Rouzioux1,4
1Paris Descartes Sorbonne-Paris-Cité University, EA 3620, Paris, France, 2Tourcoing Hospital, Infectious Diseases, Tourcoing, France, 3Faculty of Medicine Univ Paris-Sud 11, INSERM U1018, Le Kremlin-Bicêtre, France, 4AP-HP, Necker Hospital, Virology Laboratory, Paris, France, 5Timone Hospital, Infectious Diseases, Marseille, France, 6Besançon Hospital, Infectious Diseases, Besançon, France, 7AP-HP, Saint-Louis Hospital, Infectious Diseases, Paris, France, 8Paris Descartes Sorbonne-Paris-Cité, EA 3620, Paris, France, 9Timone Hospital, Virology Laboratory, Marseille, France, 10AP-HP, Bichat Hospital, Infectious Diseases, Paris, France, 11Hôtel-Dieu Hospital, Infectious Diseases, Nantes, France, 12Tenon Hospital, Infectious Diseases, Paris, France, 13AP-HP, Pitié-Salpêtrière Hospital, Infectious Diseases, Paris, France, 14INSERM, U1012, Le Kremlin-Bicêtre, France, 15Pierre & Marie Curie University, INSERM UMR-S 945, Paris, France, 16AP-HP, Pitié-Salpêtrière Hospital, Cellular and Tissular Immunology Laboratory, Paris, France, 17Pasteur Institute, Unité de Régulation des Infections Rétrovirales, Paris, France

11:15
WEAB0102
Abstract
Powerpoint
In chronically HIV-1-infected patients long-term antiretroviral therapy initiated above 500 CD4/mm3 achieves better HIV-1 reservoirs' depletion and T cell count restoration
L. Hocqueloux1, V. Avettand-Fènoël2,3, T. Prazuck1, A. Mélard2, E. Legac4, M. Niang1, C. Mille1, J. Buret1, C. Rouzioux2,3, “Coordinated Action on HIV Reservoirs” (AC32) of the ANRS (Agence Nationale de Recherches sur le Sida et les hépatites virales)
1CHR d'Orléans - La Source, Infectious and Tropical Diseases, Orleans, France, 2APHP, Hôpital Necker-Enfants Malades, Laboratory of Virology, Paris, France, 3Université Paris Descartes Sorbonne Paris Cité, Paris, France, 4CHR d'Orléans - La Source, Laboratory of Immunology, Orleans, France

11:30
WEAB0103
Abstract
Powerpoint
First study of repeat dose co-administration of GSK1265744 and TMC278 long-acting parenteral nanosuspensions: pharmacokinetics, safety and tolerability in healthy adults
W. Spreen1, P. Williams2, D. Margolis1, S. Ford1, H. Crauwels2, Y. Lou1, E. Gould1, M. Stevens2, S. Piscitelli1
1GlaxoSmithKline, Infectious Diseases Research & Development, Research Triangle Park, United States, 2Janssen Infectious Diseases BVBA, Beerse, Belgium

11:45
WEAB0104
Abstract
Powerpoint
Webcast
Efficacy of initial antiretroviral therapy: a meta-analysis of 40,124 adults with up to 144 weeks' follow-up
F.J. Lee1, J. Amin2, A. Carr1
1Clinical Research Program, St. Vincent's Centre for Applied Medical Research, Sydney, Australia, 2The Kirby Institute, University of New South Wales, Sydney, Australia

12:00
WEAB0105
Abstract
Powerpoint
Webcast
Long term therapeutic success of etravirine in switch and naive patients
L. Bull, M. Bower, M. Nelson
Chelsea and Westminster Hospital, London, United Kingdom

12:15
WEAB0106
Webcast
Moderated discussion

Powerpoints presentations
In chronically HIV-1-infected patients long-term antiretroviral therapy initiated above 500 CD4/mm3 achieves better HIV-1 reservoirs' depletion and T cell count restoration - Laurent Hocqueloux

First study of repeat dose co-administration of GSK1265744 and TMC278 long-acting parenteral nanosuspensions: pharmacokinetics, safety and tolerability in healthy adults - William Spreen

Efficacy of initial antiretroviral therapy: a meta-analysis of 40,124 adults with up to 144 weeks' follow-up - Frederick J. Lee

Long term therapeutic success of etravirine in switch and naive patients - Lauren Bull



Rapporteur report

Track B report by David Hardy


The session on ART started with a presentation on impact of 12 months of HAART in acute primary infection from France (WEAB0102) The study demonstrated that in chronically HIV-1-infected patients, long-term antiretroviral therapy initiated above 500 CD4/mm3 achieves better HIV-1 reservoirs' depletion and T cell count restoration.

 Laurent Hocqueloux and colleagues presented results from a retrospective analysis from a single-center, prospective, longitudinal French cohort (Orléans). Based on the results from the VISCONTI study in which persons with primary HIV infection(PHI) were given ART within 3 months of infection and were able to control infection after cessation of a long course of therapy (now called post-treatment controllers or PTCs), the group asked the question how long after PHI such viro-immunologic benefit remains possible. What about chronically infected patients (CHI) with CD4 nadir ≥ 500/mm3 ? The investigators  used a composite primary endpoint (PEP) of the proportion ofchronically-infected patients (i.e. Fiebig VI) under efficient cART achieving: normal CD4+ T cell count  (≥900/mm3) and a normal CD4/CD8 ratio (>1) and a low HIV-DNA level (<2.3 Logcp/106 PBMC) according to their nadir CD4+ T cell count  prior to starting ART group as < 200 cell/mm3, 200-499 cells/mm3 or >500cells/mm3. The study period ran from 2005 to 2012; 309 patients were included in the analysis. Key results demonstrated the following: If antiretroviral therapy was started at greater than 500 cells/µl then both CD4 cell restoration to a normal level of 900 cells/µl or greater, a normal CD4/CD8 ratio and a low cellular HIV-DNA level was achieved more commonly than starting ART at lower CD4 cell counts. Of further note, in a Cox model, nadir CD4+ T cell count ≥500/mm3 was the only predictor of achieving the primary endpoint: HR = 56 (95%CI:15-209),p<0.0001. The authors concluded that their results support early treatment, even in patients with high CD4 count in regard to optimal CD4+ T cell reconstitution and limiting the size to the latently HIV-infected PBMC reservoir.

In an Australian study by Lee the efficacy of initial antiretroviral therapy within a meta-analysis of 40,124 adults with up to 144 weeks follow-up was reported. In their meta-analysis the efficacy of initial combination antiretroviral therapy using data from 216 prospective studies (196 randomized; 68 placebo-controlled) including 40, 124 patients spanning the period of 1994-2010 was analyzed.  The primary endpoint for analysis was proportion of patients with undetectable viral load for the reported duration of the study of at least 48 weeks. Key reulst were a steady increase in response rates over tiem underlining that HIV therapy has become better and better. Overall, receipt of a regimen with the dual NRTI combination TDF-FTC (3TC)lead to significantly better efficacy compared to AZT-3TC or ABC-3TC. Also receipt of an integrase-containing regimen was signficantly better than one with an NNRTI or boosted PI.  Also of note, DHHS recommended “preferred regimens” demonstrated significantly better efficacy than “alternative regimens”.

 




   

    The organizers reserve the right to amend the programme.