Uptake of drug-reduced antiretroviral strategies and impact on costs over 2015–22: experience from an HIV clinic in Paris, France

L Sagaon-Teyssier; A Eremin; M A Valantin; A Fauchois; R Tubiana; S Seang; L Schneider; A Fayçal; S Saliba; M Wirden; C Soulié; G Peytavin; V Pourcher; R Agher; R Palich; C Katlama

doi:10.1093/jac/dkaf307

journal article Aug 21, 2025

Uptake of drug-reduced antiretroviral strategies and impact on costs over 2015–22: experience from an HIV clinic in Paris, France

L Sagaon-Teyssier

A Eremin

M A Valantin A Fauchois R Tubiana S Seang L Schneider A Fayçal S Saliba M Wirden

C Soulié

G Peytavin

V Pourcher

R Agher R Palich

C Katlama

Journal of Antimicrobial Chemotherapy Vol. 80 No. 10 pp. 2825-2833 · Oxford University Press (OUP)

View at Publisher Save 10.1093/jac/dkaf307

Abstract

Abstract

Background
While current HIV care includes drug-reduced antiretroviral strategies, intermittent therapy, recently recommended in France, could benefit from further evaluation in real-life clinical practice.

Objectives
To evaluate the uptake, efficacy and cost impact of drug-reduced antiretroviral strategies (DRS) in a large HIV clinic in Paris.

Methods
This retrospective study included all virally suppressed adult individuals living with HIV treated at our clinic from 2015 to 2022, on three-drug (3-DR) or two-drug (2-DR) daily regimens, with ≥1 clinical and viral load assessment recorded per year. We defined DRS as either 2-DR or intermittent oral regimen (4 or 5 days weekly). Main outcomes included DRS uptake, factors associated with DRS prescription, virological failure (VF) by ART strategy and costs.

Findings
We analysed 2170 individuals (median age: 50.6, viral suppression: 6.0 years) on daily 3-DR (77.5%) and 2-DR (22.5%). Over 8 years, 1048 participants (48.3%) switched to a DRS that consisted of intermittent ART (ART-I) in 580 participants and a 2-DR in 442 participants. The VF rate was 11.2% for 3-DR, 5.3% for 2-DR and 1.8% for intermittent ART. Overall, in 2022, 1184 participants (54.6%) were receiving a DRS. Average yearly cost of HIV care per participant dropped from €15 687 in 2015 to €7437 in 2022, with per-participant costs of €7643 for 3-DR, €8869 for 2-DR and €3388 for ART-I.

Conclusions
Drug-reduced ART regimens were prescribed to over half of the study population. Intermittent regimens, widely used in our setting, are highly effective and cost-saving, and deserve to be evaluated for implementation, particularly in resource-constrained contexts.

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Details

Published: Aug 21, 2025
Vol/Issue: 80(10)
Pages: 2825-2833
License: View

Authors

L

L Sagaon-Teyssier

Aix Marseille Univ, IRD, Inserm, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM , Marseille ,

A

A Eremin

Aix Marseille Univ, IRD, Inserm, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM , Marseille ,; Infectious Diseases Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (IPLESP), INSERM 1136 , Paris ,

M

M A Valantin

Infectious Diseases Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (IPLESP), INSERM 1136 , Paris ,

A

A Fauchois

Infectious Diseases Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (IPLESP), INSERM 1136 , Paris ,

R

R Tubiana

Infectious Diseases Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (IPLESP), INSERM 1136 , Paris ,

S

S Seang

Infectious Diseases Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (IPLESP), INSERM 1136 , Paris ,

L

L Schneider

Infectious Diseases Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (IPLESP), INSERM 1136 , Paris ,

A

A Fayçal

Infectious Diseases Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (IPLESP), INSERM 1136 , Paris ,

S

S Saliba

Infectious Diseases Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (IPLESP), INSERM 1136 , Paris ,

M

M Wirden

Virology Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (IPLESP), INSERM 1136 , Paris ,

C

C Soulié

Virology Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (IPLESP), INSERM 1136 , Paris ,

G

G Peytavin

Pharmacology Department, Bichat Claude-Bernard University Hospital, AP-HP , Paris ,

V

V Pourcher

Infectious Diseases Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (IPLESP), INSERM 1136 , Paris ,

R

R Agher

Infectious Diseases Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (IPLESP), INSERM 1136 , Paris ,

R

R Palich

Infectious Diseases Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (IPLESP), INSERM 1136 , Paris ,

C

C Katlama

Infectious Diseases Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (IPLESP), INSERM 1136 , Paris ,

Funding

Recherche et d'Études sur la Pathologie Tropicale et le Sida

Cite This Article

L Sagaon-Teyssier, A Eremin, M A Valantin, et al. (2025). Uptake of drug-reduced antiretroviral strategies and impact on costs over 2015–22: experience from an HIV clinic in Paris, France. Journal of Antimicrobial Chemotherapy, 80(10), 2825-2833. https://doi.org/10.1093/jac/dkaf307

Uptake of drug-reduced antiretroviral strategies and impact on costs over 2015–22: experience from an HIV clinic in Paris, France

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