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Antiretroviral therapy alone vs antiretroviral therapy with a kick and kill approach, on measures of the HIV reservoir in participants with recent HIV infection (the RIVER trial): A phase 2, randomised trial

The Lancet Feb 24, 2020

Fidler S, et al. - A phase 2, randomised trial was designed to ascertain the effect of ART-only versus ART plus kick and kill on markers of the HIV reservoir. This phase 2, open-label, multicentre, randomized, controlled trial was conducted at six clinical sites in the UK. Researchers randomized individuals aged 18–60 years by a computer-generated randomization list who were confirmed as HIV-positive within a maximum of the past 6 months and started ART within 1 month from confirmed diagnosis to receive ART-only (control) or ART plus the histone deacetylase inhibitor vorinostat (the kick) and replication-deficient viral vector T-cell inducing vaccines encoding conserved HIV sequences ChAdV63. This study included a total of 60 men with HIV between June 14, 2015, and Jul 11, 2017. This kick and kill method gave no significant advantage compared with ART alone on measures of the HIV reservoir. Although this does not disprove the efficacy kick and kill strategy, for future trials improvement of both kick and kill agents will be needed.
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