Impact of Increased Patient Engagement Associated With Cabotegravir (CAB) + Rilpivirine (RPV) Long-acting (LA) Administered Every Two Months on Virologically Suppressed People Living With HIV Who Are Practicing Chemsex

CHEERS is an observational cohort for people living with HIV who are actively practicing chemsex and who are switching to CAB + RPV LA after being virologically suppressed on a stable oral ART regimen. This study aim to assess the impact of increased patient engagement associated with this LA regimen on linkage to psychosocial care and on global health outcomes, such as quality of life, substance use, treatment satisfaction and virological control.
Eligible participants will need to be currently out of care for psychosocial counselling and will need to express the wish to switch to CAB + RPV LA. The participants will be followed in this study for 11 months from their first LA administration, according to the schedule of injections. In addition to standard of care procedures, such as blood draw and physical exam, patient reported outcome questionnaires will be administered at certain visits and a semi-directed interview will be conducted at the beginning and at the end of the study. CAB + RPV LA will be used in line with the Canadian monography.

开始日期2024-08-01

申办/合作机构

Clinique médicale l'Actuel

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2020-01-01·The Journal of Infectious Diseases2区 · 医学

Plasma Levels of C-Type Lectin REG3α and Gut Damage in People With Human Immunodeficiency Virus

2区 · 医学

Article

作者: Isnard, Stéphane ; Hamel, A ; Vézina, S ; Jenabian, Mohammad-Ali ; Lin, John ; Asselin, F ; Ancuta, Petronela ; de Pokomandy, A ; Goyer, M E ; Dupuy, Franck P ; Kema, Ido ; Poliquin, M ; Bernard, Nicole F ; Poulin, S ; Beauchamp, E ; Milne, M ; Klein, M ; Fortin, C ; Hal-Gagne, V ; Dufresne, S ; Turgeon, M E ; Routy, Jean-Pierre ; Lebouché, Bertrand ; Haraoui, L P ; Fombuena, Brandon ; Kerba, J P ; Maziade, P J ; Kokinov, Nikola ; Massoud, S ; Thériault, M E ; Huchet, E ; Chano, F ; Munoz, M ; Lakatos, Peter L ; Cloutier-Blais, A ; Lessard, B ; Longpré, D ; Labrecque, L ; Trottier, B ; Tremblay, Cécile ; Boissonnault, M ; Cox, J ; Rochette, P ; Lavoie, S ; Durand, Madeleine ; Milne, C ; Villielm, F ; Pilarski, R ; Deligne, B ; Sasseville, E ; Friedman, J ; Duchastel, M ; Junod, P ; Teltscher, M ; Costiniuk, Cecilia T ; Charron, M A ; Martel-Laferrière, V ; Silverman, Michael S ; Charest, L ; Ramendra, Rayoun ; Miaki, N Z

AbstractBackgroundRegenerating islet-derived protein 3α (REG3α) is an antimicrobial peptide secreted by intestinal Paneth cells. Circulating REG3α has been identified as a gut damage marker in inflammatory bowel diseases. People living with human immunodeficiency virus (PWH) on antiretroviral therapy (ART) present with an abnormal intestinal landscape leading to microbial translocation, persistent inflammation, and development of non-AIDS comorbidities. Herein, we assessed REG3α as a marker of gut damage in PWH.MethodsPlasma from 169 adult PWH, including 30 elite controllers (ECs), and 30 human immunodeficiency virus (HIV)–uninfected controls were assessed. REG3α plasma levels were compared with HIV disease progression, epithelial gut damage, microbial translocation, and immune activation markers.ResultsCross-sectionally, REG3α levels were elevated in untreated and ART-treated PWH compared with controls. ECs also had elevated REG3α levels compared to controls. Longitudinally, REG3α levels increased in PWH without ART and decreased in those who initiated ART. REG3α levels were inversely associated with CD4 T-cell count and CD4:CD8 ratio, while positively correlated with HIV viral load in untreated participants, and with fungal product translocation and inflammatory markers in all PWH.ConclusionsPlasma REG3α levels were elevated in PWH, including ECs. The gut inflammatory marker REG3α may be used to evaluate therapeutic interventions and predict non-AIDS comorbidity risks in PWH.

2018-02-20·AIDS2区 · 医学

Incidence of sexually transmitted infections before and after preexposure prophylaxis for HIV

2区 · 医学

Article

作者: Nguyen, Vinh-Kim ; Lavoie, Stéphane ; Cadieux, Martha ; Thomas, Réjean ; Tossa, Hermione Gbego ; Beauchemin, Mariève ; Charest, Louise ; Goyette, Alexandre ; Trottier, Helen ; Greenwald, Zoë R ; Longpré, Danièle

OBJECTIVEUse of preexposure prophylaxis (PrEP) for HIV raises concerns about sexually transmitted infection (STI) incidence because of decreased condom use among MSM. This study examines whether PrEP is associated with STIs in the 12 months following PrEP prescription relative to the 12 months prior to PrEP and if STI rates are higher among PrEP users relative to individuals receiving postexposure prophylaxis (PEP).DESIGNRetrospective cohort study including PrEP users with more than 12 months of follow-up before PrEP prescription and individuals receiving PEP from 2010 to 2015 at Clinique l'Actuel (Montréal, Canada).METHODSIncidence of chlamydia, gonorrhoea, syphilis and hepatitis C virus over 12 months was compared before and after PrEP; and for PrEP versus PEP users using Poisson models to generate incidence rate ratios (IRRs) with 95% confidence intervals (CIs) and adjusted IRRs (aIRRs) controlling for frequency of STI-screening visits. Models comparing PrEP and PEP users were further adjusted for age and education.RESULTSOne hundred and nine PrEP and 86 PEP users were included. Increased rates of STIs were observed in the 12 months after PrEP relative to the 12 months prior (IRR: 1.72, CI: 1.22-2.41; aIRR: 1.39, CI 0.98-1.96). PrEP users were also at higher STI risk relative to PEP users (IRR: 2.18, CI: 1.46-3.24; aIRR: 1.76, CI: 1.14-2.71).CONCLUSIONIncreased rates of STIs among individuals after initiation of PrEP may suggest greater risk behaviours during the first year on PrEP. Further studies are needed to measure long-term trends in STI acquisition following PrEP initiation.

2016-01-15·Clinical Infectious Diseases1区 · 医学

Early Initiation Rather Than Prolonged Duration of Antiretroviral Therapy in HIV Infection Contributes to the Normalization of CD8 T-Cell Counts

1区 · 医学

Article

作者: Lavoie, S ; Dufresne, S ; Li, Taisheng ; Charron, M A ; de Pokomandy, A ; Duchastel, M ; Trottier, Benoit ; Mehraj, Vikram ; Lebouche, Bertrand ; Deligne, B ; Munoz, M ; Friedman, J ; Cao, Wei ; Milne, M ; Lu, Wei ; Leblanc, Roger ; Rouleau, D ; Tremblay, Cecile ; Fortin, C ; Huchet, E ; Szabo, J ; Hal-Gagné, V ; Potter, M ; Vézina, S ; Gilmore, N ; Baril, Jean-Guy ; Labrecque, L ; Routy, Jean-Pierre ; Singer, Joel ; Turgeon, M E ; Côté, P ; Lessard, B ; Fletcher, M ; Charest, L ; Cox, Joseph ; Villielm, F ; Martel-Laferrière, V

BACKGROUNDCD8 T-cell counts remain elevated in human immunodeficiency virus (HIV) infection even after long-term antiretroviral therapy (ART), which is associated with an increased risk of non-AIDS-related events. We assessed the impact of ART initiation in early versus chronic HIV infection on trajectories of CD8 cell counts over time.METHODSOf 280 individuals enrolled during primary HIV infection (PHI), 251 were followed up for 24 months; 84 started ART before 6 months of infection (eART), 49 started between 6 and 24 months, and 118 remained untreated. Plasma HIV viral load (VL), CD4 and CD8 cell counts were assessed at each study visit. CD8 counts were also examined in 182 age-matched HIV-infected individuals who started ART during chronic infection and maintained undetectable plasma VL for ≥5 years.RESULTSAt PHI baseline, higher CD8 cell counts were associated with more recent infection (P = .02), higher CD4 cell counts (P < .001), and higher VL (P < .001). The CD8 count in the eART group decreased from 797 to 588 cells/µL over 24 months (P < .001), to a level lower than that in untreated PHI (834 cells/µL; P = .004) or in long-term-treated patients with chronic HIV infection (743 cells/µL; P = .047). More prominent CD4 T-cell recovery was observed in the eART group than in the delayed ART group.CONCLUSIONSART initiated in early HIV infection is associated with improved resolution of CD8 T-cell elevation compared with long-term ART initiated in chronic infection. Early ART may help reduce the risk of non-AIDS-related events by alleviating this elevation.

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