Reducing antiretroviral treatment is a serious avenue against HIV. At the rate of 4 doses per week, against 7, the viral load of seropositive patients remains stable.
From one intake per day to 4 per week. Heavy in side effects, antiretrovirals must currently be taken every day by people infected with HIV. A heavy treatment which causes many abandonments. Reducing the dosage seems possible. The National AIDS and Viral Hepatitis Research Agency (ANRS) presented an encouraging study at the International AIDS Conference, which is being held in Durban (South Africa) from July 18 to 22.
Lower the costs
Due to a daily intake, triple therapies require perfect compliance on the part of the patients. This is the condition for good infection control. But this rhythm is accompanied by unwanted effects like nausea, headaches or skin problems. Some molecules even cause more serious disorders, such as skin hypersensitivity or intolerance.
A study conducted in 2015 showed that space-consuming medication is possible. Going from 7 per week to 5, then 4, the viral load remains controlled. This means that the virus remains at low levels and does not, or only rarely, replicate. The ANRS this time recruited 100 patients to confirm these results. All reduced the frequency at which they ingested the triple therapies for 48 weeks. “The goal is to reduce side effects, treatment costs and improve acceptability and adherence to treatment,” said the Agency in a press release.
A well-followed treatment
For 96 volunteers, the reduction in intake did not cause an increase in the viral load, which must be less than 50 copies / mL of blood. The other three patients returned to normal analyzes as soon as the usual regimen was restored. No resistance to treatment subsequently developed.
Therapeutic relief also achieves a second objective: patient compliance. 96% were still following the 4-day-a-week pace after almost a year of follow-up. “The analysis of the compliance studies showed that the 4/7 day program was very well followed and accepted by the patients,” says Dr. Pierre de Truchis, who led the work.
These conclusions will still need to be validated in a randomized trial of volunteers. “Only a randomized trial will make it possible to approve this strategy”, specifies Jean-François Delfraissy, director of the ANRS. 640 patients will soon be recruited. They will benefit from a reduced treatment for 48 weeks. With the same objective of reducing the doses administered, the Agency is funding work on the benefits of a half-dose of medication and several dual therapies.
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