Third-line antiretroviral therapy in low-income and middle-income countries (ACTG A5288): a prospective strategy study.

The Lancet. HIV
Beatriz GrinsztejnA5288 Team

Abstract

Antiretroviral therapy (ART) management is challenging for individuals in resource-limited settings presenting for third-line treatment because of complex resistance patterns, partly due to reduced access to viral load monitoring. We aimed to evaluate use of newer antiretroviral drugs and contemporary management approaches, including population-based sequencing, to select appropriate antiretrovirals, plasma viral load monitoring, and interventions to improve adherence in individuals presenting with second-line viral failure. A5288 was a phase 4, third-line ART strategy study done at 19 urban sites in ten countries that enrolled adult participants with confirmed plasma HIV-1 RNA (viral load) of 1000 copies per mL or more after more than 24 weeks of protease inhibitor-based second-line ART. The primary objective was to use antiretrovirals (raltegravir, etravirine, and ritonavir-boosted darunavir) and diagnostic monitoring technologies, including viral load, genotyping, and adherence support to achieve viral load suppression (defined as ≤200 copies per mL) in 65% or more of participants. ART history and real-time drug resistance genotypes were used to assign participants to one of four cohorts: cohort A (no lopinavir resistance) s...Continue Reading

Citations

Feb 13, 2020·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Catherine GodfreyUNKNOWN A5288 team
Aug 21, 2020·Expert Opinion on Investigational Drugs·Fanni Boros, László Vécsei
Aug 3, 2019·The Lancet. HIV·Edward J Mills, Sabin Nsanzimana
Oct 27, 2020·Southern African Journal of HIV Medicine·Jeremy NelJoana F Woods
Feb 27, 2021·AIDS Patient Care and STDs·Anuradha SubramanianRajeshwari Krishnan
Apr 19, 2021·The Lancet Global Health·Jay J H ParkEdward J Mills
Jun 4, 2021·Journal of the International Association of Providers of AIDS Care·Paul Msanzya ZuluCassidy W Claassen

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