The trial is an open-label, multicenter, prospective, randomized trial in 2 parallel groups, evaluating at W48 the non inferiority of antiretroviral dual therapy taken 4 consecutive days per week versus antiretroviral dual therapy 7/7 days per week in HIV-1 infected patients with controlled viral load under antiretroviral dual therapy.
Open-label, multicenter, prospective, randomized trial in 2 parallel groups, evaluating at W48 the non-inferiority of antiretroviral dual therapy taken 4 consecutive days a week versus dual therapy taken 7 days a week, in HIV infected patients with controlled viral load for at least 12 months and stable antiretroviral dual therapy since 4 months. The non-inferiority margin (delta) is 5%. The randomization will be stratified according to the family of the dual therapy at the moment of the inclusion and according to the participation of the substudy or not. The sample size calculation assumes that the true difference in efficacy between the two arms is zero and that the overall response rate is 97% at week 48. A total of 440 patients (220 per arm) is required to provide 80% power to demonstrate non-inferior efficacy for the 4/7 strategy, compared to the daily dual therapy (7/7), with a two-sided significance level of 5% and a non-inferiority margin (delta) of -5%.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
440
1. Dolutégravir 50mg / Lamivudine 300mg per day 2. Dolutégravir 50mg / Rilpivirine 25mg per day 3. Darunavir/r 800mg/100mg / Lamivudine 300mg per day
Proportion of patients with virological failure at Week 48.
The virological failure is defined by 2 successive viral loads \>50 c/mL at 2 to 4 weeks apart or a viral load \> 50 c/ml with a definitive stop of the study follow-up or the study strategy
Time frame: Week 48
Proportion of participants with therapeutic success until Week 48
Time frame: Week 48
Percentage of participants with at least one episode of "blip"
viral load \>50 copies/mL followed by a control value ≤ 50 cp/mL
Time frame: Week 0 to Week48
Percentage of participants with a viral load signal detected
Time frame: Week 0 to Week 48
Evolution of ultrasensitive viral load and total DNA in the PBMC at W0 and W48
immuno-virological sub-study
Time frame: Week 0 and Week 48
Proportion of participants with acquisition of drugs resistance mutations in case of virological failure detected by Sanger and by NGS
Time frame: Week 0 to Week 48
Description of selected mutations at the virological failure
Time frame: Week 0 to Week 48
Frequency of minority resistant variants archived in DNA at W0 and their impact on virological failure (2 consecutive VL> 50 copies / mL) and on the acquisition of drugs resistance mutations
Time frame: Week 0
Frequency of grade 3 or more adverse events, adverse effects, drug-modifying adverse events, drug-related adverse events and serious adverse events (SAE)
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Hôpital Louis Pasteur/Service des Maladies Infectieuses
Chartres, Le Coudray, France
RECRUITINGCentre hospitalier Victor Dupouy/Service d'Hématologie-Unité d'Immunologie
Argenteuil, France
RECRUITINGHôpital Avicenne/Service des Maladies Infectieuses et tropicales
Bobigny, France
RECRUITINGHôpital Saint André/Service HDJ Maladies Infectieuses
Bordeaux, France
RECRUITINGHôpital Pellegrin/Service des Maladies Infectieuses et Tropicales
Bordeaux, France
RECRUITINGHôpital Côte de Nacre/Service des Maladies Infectieuses
Caen, France
RECRUITINGHôpital Antoine Béclère/Service d'Immunologie Clinique et Médecine Interne
Clamart, France
RECRUITINGCentre Hospitalier Sud-Francilien/Service d'Hématologie
Corbeil-Essonnes, France
RECRUITINGHôpital François Mitterrand/Service des Maladies Infectieuses
Dijon, France
RECRUITINGHôpital Raymond Poincaré/Service des Maladies Infectieuses
Garches, France
RECRUITING...and 28 more locations
Time frame: Week 0 to Week 48
Evolution of T CD4 and CD8 cells count, and CD4/CD8 ratio
Time frame: Week-4 to Week 48
Evolution of fasting metabolic parameters (total cholesterol total, LDL-C, HDL-C, Triglycerides and glycemia) until W0 and W48
Time frame: Week 0 to Week 48
Evolution of weight between Week 0 and Week 48
Time frame: Week 0 and Week 48
Evolution of inflammation serum parameters
immuno-virological sub-study- (sCD14, sCD163, IP-10, CRPus, IL-6, D-dimers, sTNFR1, sTNFR2) from W0 to W24 and W48
Time frame: Week 0 to Week 24 and Week 48
Evolution of semen viral load at Week 0, Week 24 and Week 48
Sub-study
Time frame: Week 0-Week 24 and Week 48
Description and comparison of plasmatic concentrations of antiretroviral agents between the 2 groups at ON and OFF period
Time frame: Week 0-Week 8-Week 24-Week 48
Evaluation of the adherence by self-reported questionnaire
Time frame: At Week 0, Week 8, Week 24, Week 36 and Week 48-the evaluation will be done after analysis of all the points
Evolution of the quality of life by self-reported questionnaire
Time frame: Week-4 to Week 48-the evaluation will be done after analysis of all the points