We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Safety and efficacy of switching to elvitegravir, cobicistat, emtricitabine, tenofovir disoproxil fumarate in treatment-experienced people with HIV: a multicenter cohort study.
- Authors
De Castro, Nathalie; Brun, Alexandre; Sellier, Pierre; Hamet, Gwenn; Mechaï, Frédéric; Garrait, Valérie; Chabrol, Amélie; Bouldouyre, Marie-Anne; Froguel, Eric; Troisvallets, Didier; Caraux-Paz, Pauline; Delaugerre, Constance; Rozenbaum, Willy; Molina, Jean-Michel
- Abstract
Objectives: We assessed the virologic efficacy of switching to co-formulated elvitegravir, cobicistat, emtricitabine, tenofovir disoproxil fumarate (E/C/F/TDF) in patients with controlled HIV infection. Methods: We conducted a retrospective multicenter observational cohort study including adult patients with controlled HIV-1 infection on any stable antiretroviral (ART) regimen, who switched to E/C/F/TDF. Success was measured by the proportion of patients with plasma viral load < 50 copies/ml at W48 using the FDA snapshot algorithm. We also assessed risk factors associated with virological failure (VF). Results: 382 patients with HIV RNA < 50 copies/mL who switched to E/C/F/TDF were included in the study. Most patients (69.9%) were male, with median age 44 years (IQR 38–51), who had been on ART for a median of 7 years (IQR 4–13). Median CD4 count was 614/mm3 and 24.6% of the patients had a history of previous virological failure. The reasons for switching were simplification (67.0%) and tolerance issues (22.0%). At week 48, 314 (82.0% [95% CI 78.4–86.0]) patients had HIV RNA < 50 copies/mL, 13 (3.5% [95% CI 3.64–8.41]) experienced virological failure. Genotype at failure was available in 6/13 patients with detection of resistance-associated mutations to integrase inhibitors and NRTIs in 5/6 (83.3%) patients. We found no predictive factor associated with virological failure except for a borderline significance with the duration of viral suppression before the switch. Tolerability of E/C/F/TDF was good with 23/382 (6.0%) patients experiencing mild adverse reactions. Conclusion: In our cohort, switching well-suppressed patients to E/C/F/TDF resulted in few virologic failures and was well tolerated. However, resistance to integrase inhibitors emerged in patients with virological failure.
- Subjects
HIV infections; RESEARCH; COMBINATION drug therapy; CLINICAL trials; SCIENTIFIC observation; CONFIDENCE intervals; HIV integrase inhibitors; VIRAL load; ANTIRETROVIRAL agents; CD4 lymphocyte count; LONGITUDINAL method; NUCLEOSIDE reverse transcriptase inhibitors
- Publication
AIDS Research & Therapy, 2023, Vol 20, Issue 1, p1
- ISSN
1742-6405
- Publication type
Article
- DOI
10.1186/s12981-022-00499-4