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    Clinical Trial Results:
    Phase III multicentre randomised trial in patients with primary HIV-1 infection evaluating the impact on reservoirs (by quantification of HIV-1 DNA in PBMC) of a combination including either raltegravir, maraviroc, darunavir/r associated with Truvada® (emtricitabine/tenofovir), or darunavir/r associated with Truvada®

    Summary
    EudraCT number
    2009-014742-28
    Trial protocol
    FR  
    Global end of trial date
    16 Dec 2013

    Results information
    Results version number
    v1(current)
    This version publication date
    23 Oct 2025
    First version publication date
    23 Oct 2025
    Other versions
    Summary report(s)
    Lancet publication

    Trial information

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    Trial identification
    Sponsor protocol code
    ANRS 147 OPTIPRIM
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01033760
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Inserm-ANRS
    Sponsor organisation address
    101 rue de Tolbiac, Paris, France, 75013
    Public contact
    Dr Antoine Chéret, Centre de Diagnostic et de Thérapeutique pluridisciplinaire CHU Point-à-Pitre, +33 5 90 89 17 40, antoine.cheret@aphp.fr
    Scientific contact
    Dr Antoine Chéret, Centre de Diagnostic et de Thérapeutique pluridisciplinaire CHU Point-à-Pitre, +33 5 90 89 17 40, antoine.cheret@aphp.fr
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    16 Dec 2013
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    16 Dec 2013
    Global end of trial reached?
    Yes
    Global end of trial date
    16 Dec 2013
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The main objective of the trial is to evaluate the impact of 24 months of optimised antiretroviral therapy versus conventional triple-agent therapy on reservoirs, measured by HIV-DNA in PBMC, in patients treated for acute or recent primary HIV-1 infection.
    Protection of trial subjects
    This study was conducted in accordance with the updated Declaration of Helsinki, in compliance with the approved protocol and its amendments, the International Council for Harmonisation guideline for Good Clinical Practice (ICH GCP), and French regulatory requirements. A phone line (through the AIDS Information Service) was set up to allow participants to ask questions about the protocol, the drugs and the HIV infection in general.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    26 Apr 2010
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    France: 90
    Worldwide total number of subjects
    90
    EEA total number of subjects
    90
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    90
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Patients were recruited from April 2010 to July 2011 in France, in 31 participating sites.

    Pre-assignment
    Screening details
    Main criteria: Inclusion: at least 18 years old, acute or primary HIV-1 infection, symptomatic primary infection or CD4<500/mm3. Non-inclusion: prior post exposure antiretroviral treatment within six months before enrolment, HIV-2 infection, pregnancy or breast-feeding.

    Period 1
    Period 1 title
    Overall trial (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Intensive cART regimen
    Arm description
    Regimen consisting of raltegravir, maraviroc, tenofovir disproxil fumarate plus emtricitabine, darunavir and ritonavir.
    Arm type
    Experimental

    Investigational medicinal product name
    Raltegravir
    Investigational medicinal product code
    Other name
    Isentress®
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    One 400 mg tablet twice daily.

    Investigational medicinal product name
    Maraviroc
    Investigational medicinal product code
    Other name
    Celsentri®
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    One 150 mg tablet morning and evening.

    Investigational medicinal product name
    Darunavir
    Investigational medicinal product code
    Other name
    Prezista®
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Two 400 mg tablet once daily with a meal.

    Investigational medicinal product name
    Ritonavir
    Investigational medicinal product code
    Other name
    Norvir®
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    One 100 mg tablet once daily with a meal.

    Investigational medicinal product name
    Emtricitabine/Tenofovir
    Investigational medicinal product code
    Other name
    Truvada®
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    One 300/200 mg tablet once daily.

    Arm title
    Standard cART regimen
    Arm description
    Regimen consisting of tenofovir disproxil fumarate plus emtricitabine, darunavir and ritonavir.
    Arm type
    Active comparator

    Investigational medicinal product name
    Darunavir
    Investigational medicinal product code
    Other name
    Prezista®
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Two 400 mg tablet once daily with a meal.

    Investigational medicinal product name
    Ritonavir
    Investigational medicinal product code
    Other name
    Norvir®
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    One 100 mg tablet once daily with a meal.

    Investigational medicinal product name
    Emtricitabine/Tenofovir
    Investigational medicinal product code
    Other name
    Truvada®
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    One 300/200 mg tablet once daily.

    Number of subjects in period 1
    Intensive cART regimen Standard cART regimen
    Started
    45
    45
    Completed
    39
    43
    Not completed
    6
    2
         Consent withdrawn by subject
    2
    1
         Lost to follow-up
    1
    -
         Discontinued strategy
    3
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Intensive cART regimen
    Reporting group description
    Regimen consisting of raltegravir, maraviroc, tenofovir disproxil fumarate plus emtricitabine, darunavir and ritonavir.

    Reporting group title
    Standard cART regimen
    Reporting group description
    Regimen consisting of tenofovir disproxil fumarate plus emtricitabine, darunavir and ritonavir.

    Reporting group values
    Intensive cART regimen Standard cART regimen Total
    Number of subjects
    45 45 90
    Age categorical
    Adults
    Units: Subjects
        In utero
    0
        Preterm newborn infants (gestational age < 37 wks)
    0
        Newborns (0-27 days)
    0
        Infants and toddlers (28 days-23 months)
    0
        Children (2-11 years)
    0
        Adolescents (12-17 years)
    0
        Adults (18-64 years)
    0
        From 65-84 years
    0
        85 years and over
    0
    Age continuous
    Units: years
        median (inter-quartile range (Q1-Q3))
    36 (30 to 47) 35 (26 to 43) -
    Gender categorical
    Units: Subjects
        Female
    2 5 7
        Male
    43 40 83

    End points

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    End points reporting groups
    Reporting group title
    Intensive cART regimen
    Reporting group description
    Regimen consisting of raltegravir, maraviroc, tenofovir disproxil fumarate plus emtricitabine, darunavir and ritonavir.

    Reporting group title
    Standard cART regimen
    Reporting group description
    Regimen consisting of tenofovir disproxil fumarate plus emtricitabine, darunavir and ritonavir.

    Primary: HIV DNA levels

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    End point title
    HIV DNA levels
    End point description
    The primary endpoint is the comparison of HIV DNA levels in circulating peripheral blood lymphocytes after two years of treatment (M24).
    End point type
    Primary
    End point timeframe
    At M24.
    End point values
    Intensive cART regimen Standard cART regimen
    Number of subjects analysed
    45
    45
    Units: log10 per 10^6 PBMCs
        median (inter-quartile range (Q1-Q3))
    2.35 (2.05 to 2.50)
    2.25 (1.71 to 2.55)
    Statistical analysis title
    HIV DNA levels comparison
    Comparison groups
    Intensive cART regimen v Standard cART regimen
    Number of subjects included in analysis
    90
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    = 0.21
    Method
    Wilcoxon rank sum test
    Confidence interval

    Adverse events

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    Adverse events information [1]
    Timeframe for reporting adverse events
    Participants reported adverse events during the entire trial.
    Adverse event reporting additional description
    Non serious adverse events were not coded for this trial. 42/45 (225 events) participants experienced AE in the Intensive cART regimen and 44/45 (272 events) in the Standard cART regimen.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    18.1
    Reporting groups
    Reporting group title
    Intensive cART regimen
    Reporting group description
    Regimen consisting of raltegravir, maraviroc, tenofovir disproxil fumarate plus emtricitabine, darunavir and ritonavir.

    Reporting group title
    Standard cART regimen
    Reporting group description
    Regimen consisting of tenofovir disproxil fumarate plus emtricitabine, darunavir and ritonavir.

    Notes
    [1] - There are no non-serious adverse events recorded for these results. It is expected that there will be at least one non-serious adverse event reported.
    Justification: Other [Not Including Serious] Adverse Events were not assessed
    Serious adverse events
    Intensive cART regimen Standard cART regimen
    Total subjects affected by serious adverse events
         subjects affected / exposed
    12 / 45 (26.67%)
    8 / 45 (17.78%)
         number of deaths (all causes)
    0
    0
         number of deaths resulting from adverse events
    0
    0
    Investigations
    Blood creatine phosphokinase increased
         subjects affected / exposed
    0 / 45 (0.00%)
    3 / 45 (6.67%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gamma-glutamyltransferase increased
         subjects affected / exposed
    1 / 45 (2.22%)
    0 / 45 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    Presyncope
         subjects affected / exposed
    1 / 45 (2.22%)
    0 / 45 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Loss of consciousness
         subjects affected / exposed
    1 / 45 (2.22%)
    0 / 45 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Pancreatitis acute
         subjects affected / exposed
    0 / 45 (0.00%)
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Hepatocellular injury
         subjects affected / exposed
    1 / 45 (2.22%)
    0 / 45 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cholestasis of pregnancy
         subjects affected / exposed
    1 / 45 (2.22%)
    0 / 45 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Lipohypertrophy
         subjects affected / exposed
    0 / 45 (0.00%)
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Psychiatric disorders
    Depression
         subjects affected / exposed
    1 / 45 (2.22%)
    0 / 45 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Suicide attempt
         subjects affected / exposed
    1 / 45 (2.22%)
    0 / 45 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Intentional overdose
         subjects affected / exposed
    1 / 45 (2.22%)
    0 / 45 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Meniscus injury
         subjects affected / exposed
    1 / 45 (2.22%)
    0 / 45 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Rhabdomyolysis
         subjects affected / exposed
    1 / 45 (2.22%)
    0 / 45 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Rotator cuff syndrome
         subjects affected / exposed
    1 / 45 (2.22%)
    0 / 45 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Acute hepatitis C
         subjects affected / exposed
    0 / 45 (0.00%)
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Anogenital warts
         subjects affected / exposed
    1 / 45 (2.22%)
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Chlamydial infection
         subjects affected / exposed
    1 / 45 (2.22%)
    0 / 45 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Eye infection syphilitic
         subjects affected / exposed
    1 / 45 (2.22%)
    0 / 45 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Human immunodeficiency virus transmission
         subjects affected / exposed
    0 / 45 (0.00%)
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lung abscess
         subjects affected / exposed
    0 / 45 (0.00%)
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Proctitis infectious
         subjects affected / exposed
    0 / 45 (0.00%)
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Shigella infection
         subjects affected / exposed
    1 / 45 (2.22%)
    0 / 45 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Viral infection
         subjects affected / exposed
    1 / 45 (2.22%)
    0 / 45 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Viral pharyngitis
         subjects affected / exposed
    1 / 45 (2.22%)
    0 / 45 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Hyperlipasaemia
         subjects affected / exposed
    0 / 45 (0.00%)
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    Intensive cART regimen Standard cART regimen
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    0 / 45 (0.00%)
    0 / 45 (0.00%)

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    10 Feb 2010
    The substantial modifications included in the amendment 1 of the protocol are: - to specify the conditions for resuming treatment for patients who have stopped treatment at the M24 visit according to the immunovirological criteria - to modify the quantity of blood planned for the biobank - to add patients who do not stop treatment at M24 to the analysis planned at M30 for the complementary immunological study "Analyse de la capacité de suppression virale des lymphocytes T CD8+ ex vivo" - to update the list of participating sites (closure of two investigating sites and change of address for another investigating site) - to add a new member to the scientific board - to identify a realeasing site for one of the trial products (darunavir)
    13 Oct 2010
    The substantial modifications included in the amendment 2 of the protocol are: - to submit the protocol for carrying out the mucosal reservoir sub-study (rectal biopsy) with some modifications concerning the routing and the number of biopsies to be taken. This sub-study had been presented in the protocol, notably in the follow-up schedule, bu the specific modalities of analysis were not yet specified. - to use the biological assessment dated less than 7 days before the D-8 visit as a pre-inclusion assessment (in order to be able to include patients in a shorter time frame) - to add HBV serology to the D-8 pre-inclusion assessment - to remove the inclusion criterion "inclusion within 10 weeks following the date of diagnosis of primary HIV infection" present in the protocol - to replace a member of the scientific board - to close two investigating centres and add a new one - to change the principal investigator of a centre - to change the formulation of one of the drug (Norvir) from capsules to tablets.
    12 Oct 2011
    The substantial modifications included in the amendment 3 of the protocol are: - to offer the complementary study "Analysis of deep reservoirs from rectal biopsies" at the M24 visit to all included patients from dedicated centres - to submit the self-questionnaires (D-8, M18 and M30) for the evaluation of the "OPTICE" device - to change the principal investigator at two sites.
    11 Apr 2012
    The substantial modifications included in the amendment 4 of the protocol are: - to change of trial sponsor - to update the list of members of the Scientific Council - a patient information note on the progress of the trial, the change of promotion and the complementary information and support system.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported

    Online references

    http://www.ncbi.nlm.nih.gov/pubmed/25900157
    http://www.ncbi.nlm.nih.gov/pubmed/25701561
    http://www.ncbi.nlm.nih.gov/pubmed/23691172
    http://www.ncbi.nlm.nih.gov/pubmed/23555774
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