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Open Access Highly Accessed Research article

Inflammatory, procoagulant markers and HIV residual viremia in patients receiving protease inhibitor monotherapy or triple drug therapy: a cross-sectional study

Miriam Estébanez1*, Natalia Stella-Ascariz2, Jesús Mingorance2, Ignacio Pérez-Valero1, Jose Ignacio Bernardino1, Francisco Xavier Zamora1, Maria Luisa Montes1, Juan Julián González-García1 and José Ramón Arribas1

Author Affiliations

1 HIV Unit, Internal Medicine Service, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain

2 Microbiology Service, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain

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BMC Infectious Diseases 2014, 14:379  doi:10.1186/1471-2334-14-379

Published: 10 July 2014

Abstract

Background

Protease inhibitor monotherapy is associated with more frequent episodes of viral rebounds above 50 copies/mL than triple therapy. Objective: To evaluate if, compared to triple-drug therapy, protease inhibitor monotherapy is associated with increased levels of inflammatory/procoagulant markers and more frequent plasma residual viremia detection.

Methods

In this cross-sectional study, we included patients treated for ≥ 1 year with darunavir/ritonavir or lopinavir/ritonavir as monotherapy (n = 72) or with two nucleos(t)ides (n = 74). All samples were tested for CRP, IL-6, fibrinogen and D-dimer. Residual viremia was determined using an ultrasensitive qualitative nested-PCR of the HIV pol gene with a limit of detection of 1 copy of HIV-RNA.

Results

We found no differences in levels of inflammatory/procoagulant markers or in the proportion of patients with plasma residual viremia detection by treatment group.

Conclusion

The long-term treatment with protease inhibitor monotherapy in the setting of routine clinical practice is not associated with a higher prevalence of plasma residual viremia or more elevated inflammatory/procoagulant markers levels than triple drug therapy.

Keywords:
HIV; Monotherapy; Inflammation; Residual viremia