A 4-days-on and 3-days-off maintenance treatment strategy for adults with HIV-1 (ANRS 170 QUATUOR): a randomised, open-label, multicentre, parallel, non-inferiority trial

Birth Country Influences the Choice of Antiretroviral Therapy in HIV-Infected Individuals: Experience From a French HIV Centre

“…In the last years, numerous clinical trials have demonstrated the noninferiority of drug-reduced ART in comparison to standard triple regimens for maintaining viral suppression, including 2-DR 31,32 and intermittent 3-DR. 33,34 We believe that these strategies should be offered to as many patients as possible, provided the virologic situation allows for it. 3…”

“…In the last years, numerous clinical trials have demonstrated the noninferiority of drug-reduced ART in comparison to standard triple regimens for maintaining viral suppression, including 2-DR 31,32 and intermittent 3-DR. 33,34 We believe that these strategies should be offered to as many patients as possible, provided the virologic situation allows for it. 3 One of the only reasons that could explain lower drugreduced ART prescriptions in PBSSAs would be the fear that they would have more resistance, assuming that the patients had had more virologic failures in the past.…”

Antiretroviral therapy adherence patterns, virological suppression, and emergence of drug resistance: A nested case–control study from Uganda and South Africa

“…Furthermore, our analysis can only be generalized to treatment-naïve populations achieving suppression rather than treatment-experienced populations maintaining suppression. For example, we have shown much lower rates of average adherence are needed to maintain suppression [15], and a recent clinical trial demonstrates that suppressed individuals can generally maintain suppression with lower average adherence and 3-day treatment gaps [16]. Finally, interrogating a single ART regimen limits the generalizability of our findings.…”

Beyond Undetectable: Modeling the Clinical Benefit of Improved Antiretroviral Adherence in Persons With Human Immunodeficiency Virus With Virologic Suppression

“…Outside of the need for an interventional trial, studies of surrogate endpoints (eg, biomarkers of inflammation and preclinical disease) could assess the impact of adherence beyond viral suppression. In fact, several recent randomized studies, including the QUATUOR and BREATHER studies, have established noninferiority of less-than-daily ART dosing in well-controlled PWH for maintenance of viral suppression, without an increase in biomarkers of inflammation, immune activation, or coagulopathy in the non-daily ART arm [ 4 , 30 ]. However, the study populations in these trials were followed for short periods of time and were highly selected for long-standing suppression with specific ART regimens, which may not represent the majority of ART-treated PWH.…”