Effect of monotherapy with darunavir/cobicistat on viral load and semen quality of HIV-1 patients

PLoS One. 2018 Apr 24;13(4):e0196257. doi: 10.1371/journal.pone.0196257. eCollection 2018.

Abstract

Many patients previously using darunavir/ritonavir (DRV/r) (800/100mg) have switched to darunavir/cobicistat (DRV/C) (800/150 mg) either as part of triple therapy (ART) or as monotherapy with DRV (mDRV). The latter approach continues to be used in some countries for patients receiving long-term treatment. However, to date, the behaviour of DRV/C in the seminal compartment has not been analysed. This study explores how the combination behaves in monotherapy, with respect to the control of viral load and seminal quality. To this end, we studied 20 patients who were treated with mDRV/C after previous treatment with mDRV/r for at least 24 weeks. A viral load control in seminal plasma similar to that published in the literature was observed after 24 weeks of treatment with mDRV/C (viral load positivity in 20% of patients). Similarly, semen quality was confirmed (70% normozoospermic) in patients treated with this formulation, as has previously been reported for ART and mDRV/r. The DRV levels measured in seminal plasma were above EC50, regardless of whether the seminal viral load was positive or negative. We conclude that this mDRV/C co-formulation behaves like mDRV/r in seminal plasma in terms of viral load control and semen quality.

MeSH terms

  • Adult
  • Antiretroviral Therapy, Highly Active / adverse effects
  • Cobicistat / administration & dosage*
  • Cobicistat / adverse effects
  • Cohort Studies
  • Darunavir / administration & dosage*
  • Darunavir / adverse effects
  • Drug Therapy, Combination / adverse effects
  • HIV Infections / drug therapy*
  • HIV Infections / virology
  • HIV Protease Inhibitors / administration & dosage*
  • HIV Protease Inhibitors / adverse effects
  • HIV-1 / drug effects
  • HIV-1 / physiology
  • Humans
  • Male
  • Middle Aged
  • Semen / drug effects*
  • Semen / virology
  • Semen Analysis
  • Viral Load / drug effects*

Substances

  • HIV Protease Inhibitors
  • Cobicistat
  • Darunavir

Grants and funding

The authors received no specific funding for this work.