%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Sripan, Patumrat
%A Le Coeur, S.
%A Ingsrisawang, L.
%A Cressey, T. R.
%A Bouazza, N.
%A Foissac, F.
%A Ngo-Giang-Huong, Nicole
%A Traisathit, P.
%A Srirompotong, U.
%A Ayudhaya, O. P. N.
%A Puangsombat, A.
%A Jungpipun, J.
%A Jittayanun, K.
%A Treluyer, J. M.
%A Jourdain, Gonzague
%A Lallemant, Marc
%A Urien, S.
%T Contribution of different antiretroviral regimens containing zidovudine, lamivudine and ritonavir-boosted lopinavir on HIV viral load reduction during pregnancy
%D 2016
%L fdi:010069356
%G ENG
%J Antiviral Therapy
%@ 1359-6535
%K THAILANDE
%M ISI:000396089500008
%N 5
%P 435-440
%R 10.3851/imp3001
%U https://www.documentation.ird.fr/hor/fdi:010069356
%> https://www.documentation.ird.fr/intranet/publi/2017/04/010069356.pdf
%V 21
%W Horizon (IRD)
%X Background: Antiretroviral (ARV) regimens used for the prevention of mother-to-child transmission of HIV have evolved over time. We evaluated the contribution of different ARV regimens on the reduction of the plasma HIV RNA viral load (VL) during pregnancy. Methods: A total of 1,833 VL measurements from ARV-naive pregnant women participating in perinatal prevention trials in Thailand were included. Women received either zidovudine (ZDV) monotherapy, ZDV plus lopinavir/ritonavir (LPV/r), or ZDV plus lamivudine (3TC) plus LPV/r. VL time-course during pregnancy was described as a function of pretreatment VL and treatment duration using an E max non-linear mixed-effect model. VL reduction and median time to achieve a VL< 50 copies/ml were estimated for each regimen. Results: Among 745 women, 279 (37%), 145 (20%) and 321 (43%) received ZDV monotherapy, ZDV+ LPV/r and ZDV+ 3TC+ LPV/r, respectively. The predicted VL reduction from baseline to delivery after a median of 10 weeks of treatment were 0.5, 2.7 and 2.9 log 10 copies/ml with ZDV monotherapy, ZDV+ LPV/r and ZDV+ 3TC+ LPV/r, respectively. At delivery, 1%, 57% and 63% of women receiving ZDV monotherapy, ZDV+ LPV/r or ZDV+ 3TC+ LPV/r had a VL< 50 copies/ml. The addition of 3TC to ZDV+ LPV/r reduced the time to achieve a VL< 50 copies/ml and the higher the pretreatment VL, the larger the effect 3TC had on reducing the time to VL< 50 copies/ml. Conclusions: The addition of 3TC to ZDV+ LPV/r was associated with a slight further VL reduction but the time to reach a VL< 50 copies/ml was shorter. This beneficial effect of 3TC is crucial for prevention of mother-to-child transmission in women who receive ARVs late and with high pretreatment VL.
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