{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T20:04:13Z","timestamp":1760385853980,"version":"3.40.5"},"reference-count":20,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,5,8]],"date-time":"2021-05-08T00:00:00Z","timestamp":1620432000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/L00528X\/1"],"award-info":[{"award-number":["MR\/L00528X\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Rapid initiation of antiretroviral therapy (ART) is important for individuals with high baseline viral loads, such as in primary HIV\u20101 infection (PHI). Four\u2010drug regimens are sometimes considered; however, data are lacking on tolerability. We aimed to evaluate the tolerability of four\u2010drug regimens used in the Research in Viral Eradication of HIV\u20101 Reservoirs (RIVER) study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>At enrolment, ART\u2010na\u00efve adult participants or those newly commenced on ART were initiated or intensified to four\u2010drug regimens within\u00a04\u00a0weeks of PHI. Rapid start was defined as pre\u2010confirmation or \u2264\u00a07\u00a0days of confirmed diagnosis. Primary and secondary outcomes were patient\u2010reported adherence measured by 7\u2010day recall and regimen switches between enrolment and randomization, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 54 men were included: 72.2% were of white ethnicity, with a median age of 32\u00a0years old, 42.6% had a viral load of \u2265\u00a0100\u00a0000 HIV\u20101 RNA copies\/mL, and in 92.6% sex with men was the mode of acquisition of HIV\u20101. Twenty (37%) started a four\u2010drug regimen and 34 (63%) were intensified. Rapid ART initiation occurred in 28%, 100% started in \u2264\u00a04\u00a0weeks. By weeks 4, 12, and 24, 37.0%, 69.0%, and 94.0% were undetectable (viral load &lt;\u00a050 copies\/mL), respectively. Adherence rates of 100% at weeks 4, 12, 22 and 24 were reported in 88.9%, 87.0%, 82.4% and 94.1% of participants, respectively. Five individuals switched to three drugs, four changed their regimen constituents, and two switched post\u2010randomization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Overall, four\u2010drug regimens were well tolerated and had high levels of adherence. Whilst their benefit over three\u2010drug regimens is lacking, our findings should provide reassurance if a temporarily intensified regimen is clinically indicated to help facilitate treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.13118","type":"journal-article","created":{"date-parts":[[2021,5,9]],"date-time":"2021-05-09T08:04:41Z","timestamp":1620547481000},"page":"770-774","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Tolerability of four\u2010drug antiretroviral combination therapy in primary HIV\u20101 infection"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3282-4998","authenticated-orcid":false,"given":"JE","family":"Burns","sequence":"first","affiliation":[{"name":"Centre for Clinical Research in Infection and Sexual Health Institute for Global Health University College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W","family":"St\u00f6hr","sequence":"additional","affiliation":[{"name":"Medical Research Council Clinical Trials Unit Institute of Clinical Trials and Methodology University College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Kinloch\u2010De Loes","sequence":"additional","affiliation":[{"name":"Department of Infection and Immunity Royal Free Hospital London UK"},{"name":"Institute of Immunity &amp; Transplantation University College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Fox","sequence":"additional","affiliation":[{"name":"Department of Genitourinary Medicine and Infectious Diseases, Guys and St Thomas\u2019 NHS Trust London UK"},{"name":"Department of Genitourinary Medicine and Infectious Diseases NIHR Biomedical Research Centre King\u2019s College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Clarke","sequence":"additional","affiliation":[{"name":"Elton John Centre Brighton UK"},{"name":"Department of HIV and Sexual Health Sussex University Hospital Brighton UK"},{"name":"Brighton and Sussex Medical School University of Sussex Brighton UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Nelson","sequence":"additional","affiliation":[{"name":"Department of HIV Medicine Chelsea and Westminster Hospital Imperial College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Thornhill","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Imperial College London London UK"},{"name":"NIHR Imperial Biomedical Research Centre London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Babiker","sequence":"additional","affiliation":[{"name":"Medical Research Council Clinical Trials Unit Institute of Clinical Trials and Methodology University College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Frater","sequence":"additional","affiliation":[{"name":"Nuffield Department of Medicine Oxford University Oxford UK"},{"name":"Nuffield Department of Medicine Oxford NIHR Biomedical Research Centre Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"SL","family":"Pett","sequence":"additional","affiliation":[{"name":"Centre for Clinical Research in Infection and Sexual Health Institute for Global Health University College London London UK"},{"name":"Medical Research Council Clinical Trials Unit Institute of Clinical Trials and Methodology University College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Fidler","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Imperial College London London UK"},{"name":"NIHR Imperial Biomedical Research Centre London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,5,8]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1506816"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1507198"},{"key":"e_1_2_7_4_1","doi-asserted-by":"crossref","unstructured":"British HIV Association.British HIV Association. BHIVA Guidelines for the treatment of HIV\u20101\u2010positive adults with antiretroviral therapy 2016 interim update.2016.","DOI":"10.21864\/jbgtha.2016.13"},{"key":"e_1_2_7_5_1","unstructured":"European AIDS Clinical Society.European AIDS clinical society guidelines.European AIDS Clinical Society.2019;10.0."},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002357"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001134"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1128\/JVI.01046-14"},{"key":"e_1_2_7_9_1","article-title":"Rapid initiation of antiretroviral therapy for people living with HIV","volume":"6","author":"Mateo\u2010Urdiales A","year":"2019","journal-title":"Cochrane Database of Systematic Reviews."},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1086\/512088"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1089\/aid.2011.0137"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep32947"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.17.4.19774"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dky211"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)32990-3"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.12284"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001537"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2017.01.012"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkaa309"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(15)70021-6"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000000111"}],"container-title":["HIV Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.13118","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/hiv.13118","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.13118","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T13:23:17Z","timestamp":1699017797000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hiv.13118"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,8]]},"references-count":20,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["10.1111\/hiv.13118"],"URL":"https:\/\/doi.org\/10.1111\/hiv.13118","archive":["Portico"],"relation":{},"ISSN":["1464-2662","1468-1293"],"issn-type":[{"type":"print","value":"1464-2662"},{"type":"electronic","value":"1468-1293"}],"subject":[],"published":{"date-parts":[[2021,5,8]]},"assertion":[{"value":"2021-04-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-08","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}