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Debating The Merits of Monotherapy For HIV

Debating The Merits of Monotherapy For HIV. José Arribas , MD Laurent Cotte , MD Réjean Thomas, MD. Risk ratios for maintaining viral suppression, intention to treat analysis, 48 week follow-up, viral suppression < 50 copies/ ml.

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Debating The Merits of Monotherapy For HIV

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  1. Debating The Merits of Monotherapy For HIV José Arribas, MD Laurent Cotte, MD Réjean Thomas, MD

  2. Risk ratios for maintaining viral suppression, intention to treat analysis, 48 week follow-up, viral suppression < 50 copies/ml Mathis S, et al. Effectiveness of protease inhibitor monotherapy versus combination antiretroviral maintenance therapy: a meta-analysis. PLoS One. 2011;6(7):e22003. Epub 2011 Jul 19.

  3. Paper #479 NCI Prevalence (wk48): 30% in mono-LPV/r vs 32% in TDF/3TC/LPV/r (p = 0.85). NCI Incidence 6% in mono-LPV/r vs 7% in TDF/3TC/LPV/r (p = 0.85). No significant differences in neuropsychological tests Paper #483 Undetectable CSF Viral Load CSF for all but 3 MT patients and in 1 HAART patient (18% vs 6%, p = 0.601). NCI observed in 7 patients on MT and 10 patients on HAART (41% vs 59%; p = 0.494). Global Deficit Score showed differences between groups, indicating better rates in MT group (0.23 [±0.20] vs 0.46 [±0.30]; p = 0.025) Monotherapy and Neurocognitive Impairment at CROI 2012 - Positive Results Bunupuradah T. et al. Neurocognitive Impairments in Patients Using Lopinavir/ritonavir MonotherapyvsLopinavir/ritonavir-based HAART. CROI 2012 Paper #479 Santos J., et al. Long-term Monotherapy with Lopinavir/ritonavir (>2 Years) Is Not Associated with Greater HIV-associated Neurocognitive Impairment. CROI 2012 Paper #483

  4. Monotherapy and Neurocognitive Impairment at CROI 2012 – Negative Results • Paper #480 • Higher CSF levels of S100-beta (570 ± 1132) & neopterin (2.5 ± 2.9) in monotherapy (MT) versus conventional therapy (CT) (0 ± 532, p = 0.002 and 1.2 ± 2.5, p = 0.058, respectively) S100-beta p=0.002 Neopterin p=0.058 Neopterin p=0.058 S100-beta p=0.002 MT CT MT CT MT CT MT CT Du Pasquier R. et al. Rapid Increase of Astrocytic and Inflammatory Markers in the Cerebrospinal Fluid of HIV+ Patients on Lopinavir/ritonavir Monotherapy. CROI 2012 Paper #480

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