{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T10:38:55Z","timestamp":1752230335503,"version":"3.37.3"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2018,10,22]],"date-time":"2018-10-22T00:00:00Z","timestamp":1540166400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["UM1AI068633","UM1AI068615","UM1AI106707"],"award-info":[{"award-number":["UM1AI068633","UM1AI068615","UM1AI106707"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,7,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>A vaginal ring containing dapivirine, a non-nucleoside human immunodeficiency virus (HIV)-1 reverse transcriptase inhibitor (NNRTI), was safe and effective in preventing HIV-1 infection in African women. We examined the impact of dapivirine ring use at the time of HIV-1 acquisition on subsequent HIV-1 disease progression and responses to NNRTI-containing antiretroviral therapy (ART).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>HIV-1 disease progression and virologic failure following initiation of ART were assessed among women who acquired HIV-1 while participating in Microbicide Trials Network\u2013020, a randomized, placebo-controlled trial of a monthly, dapivirine vaginal ring.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among the 158 participants who acquired HIV-1 (65 dapivirine, 93 placebo), no differences between dapivirine and placebo participants were observed in CD4+ cell counts or plasma HIV-1 RNA over the first year after infection (prior to ART). During follow-up, 100\/158 (63%) participants initiated NNRTI-containing ART (dapivirine: 39\/65; placebo: 61\/93); the median time to HIV-1 RNA &lt;200 copies\/ml was approximately 90 days for both dapivirine and placebo ring recipients (log-rank P = .40). Among the 81 participants with at least 6 months of post-ART follow-up, 19 (24%) experienced virologic failure (dapivirine: 6\/32, 19%; placebo: 13\/39, 27%; P = .42).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The acquisition of HIV-1 infection during dapivirine or placebo treatment in ASPIRE did not lead to differences in HIV-1 disease progression. After the initiation of NNRTI-containing ART, dapivirine and placebo participants had similar times to virologic suppression and risks of virologic failure. These results provide reassurance that NNRTI-based ART regimens are effective among women who acquired HIV-1 while receiving the dapivirine vaginal ring.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Trials Registration<\/jats:title>\n                  <jats:p>NCT016170096 and NCT00514098.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciy909","type":"journal-article","created":{"date-parts":[[2018,10,18]],"date-time":"2018-10-18T15:20:27Z","timestamp":1539876027000},"page":"523-529","source":"Crossref","is-referenced-by-count":11,"title":["Clinical and Virologic Outcomes Following Initiation of Antiretroviral Therapy Among Seroconverters in the Microbicide Trials Network-020 Phase III Trial of the Dapivirine Vaginal Ring"],"prefix":"10.1093","volume":"69","author":[{"given":"Sharon A","family":"Riddler","sequence":"first","affiliation":[{"name":"University of Pittsburgh, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer E","family":"Balkus","sequence":"additional","affiliation":[{"name":"University of Washington, Seattle"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Urvi M","family":"Parikh","sequence":"additional","affiliation":[{"name":"University of Pittsburgh, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John W","family":"Mellors","sequence":"additional","affiliation":[{"name":"University of Pittsburgh, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolyne","family":"Akello","sequence":"additional","affiliation":[{"name":"Makerere University\u2013Johns Hopkins University Research Collaboration, Kampala, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sufia","family":"Dadabhai","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health, Blantyre, Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix","family":"Mhlanga","sequence":"additional","affiliation":[{"name":"University of Zimbabwe, Harare"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gita","family":"Ramjee","sequence":"additional","affiliation":[{"name":"South African Medical Research Council, Durban"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashley J","family":"Mayo","sequence":"additional","affiliation":[{"name":"FHI 360, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward","family":"Livant","sequence":"additional","affiliation":[{"name":"Magee-Womens Research Institute & Foundation, Pittsburgh, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy L","family":"Heaps","sequence":"additional","affiliation":[{"name":"University of Pittsburgh, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colin","family":"O\u2019Rourke","sequence":"additional","affiliation":[{"name":"University of Washington, Seattle"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jared M","family":"Baeten","sequence":"additional","affiliation":[{"name":"University of Washington, Seattle"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"MTN-015 and MTN-020\/ASPIRE Study Teams","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2018,10,22]]},"reference":[{"key":"2019071803461318400_CIT0001","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1056\/NEJMoa1108524","article-title":"Antiretroviral prophylaxis for HIV prevention in heterosexual men and women","volume":"367","author":"Baeten","year":"2012","journal-title":"N Engl J 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