High rate of virologic suppression with darunavir/ritonavir plus optimized background therapy among highly antiretroviral-experienced HIV-infected patients: results of a prospective cohort study in São Paulo, Brazil

Abstract

Darunavir/ritonavir plus optimized background therapy was a highly effective salvage regimen under clinical routine conditions in a referral center in Brazil, which is similar to the reported in high-income countries.

Virological response and resistance profile in HIV‐1‐infected patients starting darunavir‐containing regimens

“…Beyond these excellent results for DRV/r used in first‐line cART, in the present study DRV/r also showed very good results in PI‐experienced patients, confirming, but with an even higher success rate, data from previous clinical trials . Indeed, by 12 months of DRV/r treatment, the high VS rate observed in PI‐experienced patients (84.3%) was comparable to that observed in other studies evaluating data from clinical practice . The high VS rate found in our analysis can be explained by the fact that, as a consequence of the evaluation of GRT results at baseline, the majority of these patients had viruses susceptible to both DRV/r and the optimized backbone.…”

“…As previously observed in two Brazilian studies evaluating the response to DRV/r in clinical practice , we found a negative association between baseline viraemia >100 000 copies/mL and DRV/r response in PI‐experienced patients. Regarding resistance emergence at failure, a low prevalence of acquired resistance to DRV or other drugs in the regimen was also observed in PI‐experienced patients.…”

“…Interestingly, although DRV/r was inferior in terms of efficacy to INIs , it showed a lower resistance level at virological failure compared with drugs with a low/intermediate genetic barrier such as raltegravir or efavirenz . Few data on the DRV/r response and resistance profile are available from clinical practice in antiretroviral‐naïve and treatment‐experienced patients . Little information is also available about the impact of pre‐antiretroviral therapy (ART) viraemia in patients treated with DRV/r in the usual clinical setting.…”

Zimbabwe’s national third-line antiretroviral therapy program: Cohort description and treatment outcomes

“…Our data demonstrated the effectiveness of third-line ART in a programme where the predominant subtype was C. Our findings are in line with other studies from the region that demonstrated good virological suppression rates among patients receiving third-line ART [11,12,23]. Findings from studies in resource limited settings have demonstrated that virologic suppression is a realistic endpoint for most treatment-experienced patients who begin a darunavir-based third-line therapy outside the controlled conditions of a randomized trial, at routine care settings [24][25][26]. NC has a very intense program to help prepare patients for thirdline ART which includes a six-week enhanced adherence support program.…”

Efetividade virológica e imunológica de darunavir/ritonavir associado a um esquema de base otimizado em pacientes experimentados em terapia antirretroviral e infectados por HIV-1: estudo observacional retrospectivo no Instituto de Infectologia Emílio Ribas

“…37,40,42 Para composição de esquemas de resgate, o DRV é utilizado na dose de 600 mg de DRV associado a 100 mg de RTV, duas vezes ao dia, embora estudos realizados já mostraram não inferioridade da dose de 800 mg de DRV associado a 100 mg de RTV, para pacientes experimentados. 40,43,44,45 São descritos poucos efeitos adversos, incluindo sintomas gastrointestinais e hiperlipidemia. Exantema e reações cutâneas graves, com síndrome de Stevens-Johnson e eritema multiforme, também foram descritos, mas em poucos casos.…”