Universität zu Köln

Stecher, Melanie, Classen, Annika, Klein, Florian, Lehmann, Clara, Gruell, Henning, Platten, Martin, Wyen, Christoph, Behrens, Georg, Faetkenheuer, Gerd and Vehreschild, Joerg Janne (2020). Systematic Review and Meta-analysis of Treatment Interruptions in Human Immunodeficiency Virus (HIV) Type 1-infected Patients Receiving Antiretroviral Therapy: Implications for Future HIV Cure Trials. Clin. Infect. Dis., 70 (7). S. 1406 - 1418. CARY: OXFORD UNIV PRESS INC. ISSN 1537-6591

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Abstract

Background. Safety and tolerability of analytical treatment interruptions (ATIs) as a vital part of human immunodeficiency virus type 1 (HIV-1) cure studies are discussed. We analyzed current evidence for the occurrence of adverse events (AEs) during TIs. Methods. Our analysis included studies that reported on AEs in HIV-1-infected patients undergoing TIs. All interventional and observational studies were reviewed, and results were extracted based on predefined criteria. The proportion of AEs was pooled using random-effects models. Metaregression was used to explore the influence of baseline CD4+ T-cell count, viral load, study type, previous time on combined antiretroviral therapy, and follow-up interval during TIs. Results. We identified 1048 studies, of which 22 studies including 7104 individuals fulfilled the defined selection criteria. Included studies had sample sizes between 6 and 5472 participants, with durations of TI cycles ranging from 7 days to 27 months. The intervals of HIV-1-RNA testing varied from 2 days to 3 months during TIs. The overall proportion of AEs during TIs >4 weeks was 3% (95% confidence interval [CI], 0%-7%) and was lower in studies with follow-up intervals <= 14 days (0%; 95% CI, 0%-1%) than in studies with wider follow-up intervals (6%; 95% CI, 2%-13%; P value for interaction =.01). Conclusions. We found moderate-quality evidence indicating that studies with narrow follow-up intervals did not show a substantial increase in AEs during TIs. Our findings indicate that ATI may be a safe strategy as part of HIV-1 cure trials by closely monitoring for HIV-1 rebound.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Stecher, Melanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Classen, Annika UNSPECIFIED UNSPECIFIED UNSPECIFIED Klein, Florian UNSPECIFIED UNSPECIFIED UNSPECIFIED Lehmann, Clara UNSPECIFIED UNSPECIFIED UNSPECIFIED Gruell, Henning UNSPECIFIED UNSPECIFIED UNSPECIFIED Platten, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Wyen, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Behrens, Georg UNSPECIFIED UNSPECIFIED UNSPECIFIED Faetkenheuer, Gerd UNSPECIFIED UNSPECIFIED UNSPECIFIED Vehreschild, Joerg Janne UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-338363
DOI:	10.1093/cid/ciz417
Journal or Publication Title:	Clin. Infect. Dis.
Volume:	70
Number:	7
Page Range:	S. 1406 - 1418
Date:	2020
Publisher:	OXFORD UNIV PRESS INC
Place of Publication:	CARY
ISSN:	1537-6591
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language STRUCTURED TREATMENT INTERRUPTIONS; INFECTED PATIENTS; T-CELLS; DISCONTINUATION; CONSEQUENCES; INTERMITTENT; DYNAMICS; OUTCOMES; TERM Multiple languages Immunology; Infectious Diseases; Microbiology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/33836