Durability of different initial regimens in HIV-infected patients starting antiretroviral therapy with CD4+ counts &lt;200 cells/mm3 and HIV-RNA &gt;5 log10 copies/mL

Gianotti, Nicola; Lorenzini, Patrizia; Cozzi‐Lepri, Alessandro; Luca, Andrea De; Madeddu, Giordano; Sighinolfi, Laura; Pinnetti, Carmela; Santoro, Carmen Rita; Meraviglia, Paola; Mussini, Cristina; Antinori, Andrea; Monforte, Antonella d’Arminio; Andreoni, Massimo; Angarano, Gioacchino; Castelli, Francesco; Cauda, Roberto; Perri, Giovanni Di; Galli, Massimo; Iardino, R.; Ippolito, Giuseppe; Lazzarin, Adriano; Perno, Carlo Federico; Schloesser, F. von; Viale, Pierluigi; Castagna, Antonella; Ceccherini‐Silberstein, Francesca; Girardi, Erika; Caputo, Sergio Lo; Puoti, Massimo; Ammassari, Adriana; Balotta, Claudia; Bandera, Alessandra; Bonfanti, Paolo; Bonora, Stefano; Borderi, Marco; Calcagno, Andrea; Calza, Leonardo; Capobianchi, M.R.; Cingolani, Antonella; Cinque, Paola; Biagio, Antonio Di; Gori, Andrea; Guaraldi, Giovanni; Lapadula, Giuseppe; Lichtner, Miriam; Maggiolo, Franco; Marchetti, Giulia; Marcotullio, Simone; Monno, Laura; Nozza, Silvia; Quiros-Roldan, Eugenia; Rossotti, Roberto; Rusconi, Stefano; Saracino, Annalisa; Zaccarelli, Mauro; Fanti, Iuri; Rodanò, A.; Shanyinde, Milensu; Tavelli, Alessandro; Carletti, Fabrizio; Carrara, Sandro; Di, Antonino; Graziano, Silvia; Petrone, Fabrizio; Prota, Gennaro; Quartu, Serena; Truffa, Silvia; Giacometti, Andrea; Costantini, Andrea; Valeriani, C.; Suardi, C.; Donati, Valentina; Verucchi, Gabriella; Quirós, Esther; Minardi, C; Quirino, Tiziana; Abeli, C.; Manconi, Paolo Emilio; Piano, P.; Cacopardo, Bruno; Celesia, Benedetto Maurizio; Vecchiet, Jacopo; Falasca, Katia; Segala, Daniela; Mazzotta, Francesco; Vichi, Francesca; Cassola, Giovanni; Viscoli, Claudio; Alessandrini, A.; Bobbio, Nicoletta; Mazzarello, Giovanni; Mastroianni, Claudio Maria; Belvisi, Valeria; Caramma, Ilaria; Chiodera, Alessandro; Rizzardini, Giuliano; Ridolfo, Annalisa; Piolini, R.; Carenzi, Laura; Moioli, M. C.; Tincati, Camilla; Puzzolante, Cinzia; Abrescia, Nicola G. A.; Chirianni, Antonio; Borgia, Guglielmo; Martino, Filomena Di; Maddaloni, L.; Gentile, I.; Orlando, Raffaele; Baldelli, Franco; Francisci, Daniela; Parruti, Giustino; Ursini, Tamara; Magnani, Giacomo; Ursitti, M. A.; Vullo, Vincenzo; Cristaudo, Alfonso; Baldin, Gianmaria; Cicalini, Stefania; Gallo, L.; Nicastri, Emanuele; Acinapura, R.; Capozzi, M.; Libertone, Raffaella; Savinelli, Stefano; Latini, Alessandra; Cecchetto, M.; Viviani, Filippo; Mura, María Stella; Rossetti, Barbara; Caramello, Pietro; Orofino, Giancarlo; Sciandra, Mauro; Bassetti, Matteo; Londero, Angela; Pellizzer, G.; Manfrin, Vinicio

doi:10.1093/jac/dkz237

Cited by 14 publications

(15 citation statements)

References 23 publications

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“…Traditionally, InSTIs are combined with two nucleos(t) ide reverse transcriptase inhibitors in a three-drug regimen (3DR). The InSTI-based 3DRs have shown good efficacy and durability both in clinical trials [14,15] and in real-life settings [16][17][18]. Recently, dolutegravir, a last-generation InSTI characterized by a high genetic barrier, has been evaluated for the treatment of HIV infection in two-drug regimens (2DRs) with encouraging results.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and durability of two‐ vs. three‐drug integrase inhibitor‐based regimens in virologically suppressed HIV‐infected patients: Data from real‐life ODOACRE cohort

et al. 2021

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Section: Introductionmentioning

confidence: 99%

Efficacy and durability of two‐ vs. three‐drug integrase inhibitor‐based regimens in virologically suppressed HIV‐infected patients: Data from real‐life ODOACRE cohort

et al. 2021

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“…They concluded that starting ART with NNRTIs versus starting with bPIs; and starting ART with InSTIs versus starting with NNRTIs were less likely associated with treatment failure. Therefore, the durability of InSTIsbased regimen was longer than that of NNRTI-and bPI-based regimens [13]. The informations of percentage of STR uses were lack.…”

Section: Resultsmentioning

confidence: 99%

Durability of Single Tablet Regimen for Patients with HIV infection in Southern Taiwan: data from a real world setting

Chang

Chou

Tsai

2020

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Background: A single-tablet regimen (STR) has been associated with better drug adherence. However, the durability of different STRs was unknown in the real world settings. Our aim was to investigate the durability of different initial STR regimens in patients starting STR in southern Taiwan Method: This was a retrospective study of antiretroviral-naive patients that initiated first-line antiretroviral regimens with STRs between May 2016 and December 2017. The primary endpoint was time to virological failure (defined as plasma HIV RNAs≧200 copies/mL after 24 weeks). Secondary endpoints were STR discontinuation due to toxicity/intolerance. Survival analysis was done using Kaplan–Meier and Cox regression. Results: Two hundred and twenty-three patients were included: Over a median (IQR) of 86 (60-112) weeks, 25 patients (11%) experienced virological failure; the 1 year probability of virological failure was 11% (8/70) for Atripla, 7% (4/54) for Complera and 13% (13/99) for Triumeq. Fifty-six patients (25%) discontinued their STRs owing to toxicity/intolerance. When compared to Atripla, treatment with Complera (AHR 8.39, CI 1.98-35.58, p=0.004) and Triumeq (AHR 8.40, CI 2.39-29.54, p=0.001) were more likely to have treatment failure. However, when the risk of treatment failure was compared between two different STRs, treatment with Complera was not found to have higher risk of treatment failure when compared to Atripla (log rank test p=0.116). The predictors for treatment failure included age≦30 years old (AHR 3.73, CI 1.25-11.17, p=0.018), switch between different STR (AHR 2.3, CI 1.18-4.50, p=0.001) and free of active syphilis infection (AHR 0.24, CI 0.08-0.73, p=0.012). The risk factor for treatment discontinuation included younger age≦30 years old (AHR 3.82, CI 1.21-12.37, p=0.023), treatment with Atripla (AHR 8.65 , CI 2.64-28.39 , p<0.001) and free of active syphilis infection (AHR0.16, CI 0.04-0.62, p=0.006). Conclusion: Younger age was associated with treatment failure and drug discontinuation. Active syphilis infection s/p treatment was associated with free from treatment failure and discontinuation. This probably driven by the more frequently sexual health education and counseling when patients had syphilis infection. The STR durability was dependent on the drug toxicity/intolerance, age and syphilis infection

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“…They concluded that starting ART with NNRTIs versus starting with bPIs; and starting ART with InSTIs versus starting with NNRTIs were less likely associated with treatment failure. Therefore, the durability of InSTIs-based regimen was longer than that of NNRTI-and bPI-based regimens [13]. The informations of percentage of STR uses were lack.…”

Section: Discussionmentioning

confidence: 99%

Durability of Single Tablet Regimen for Patients with HIV infection in Southern Taiwan: data from a real world setting

Chang

Chou

Tsai

2020

Preprint

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Background: A single-tablet regimen (STR) has been associated with better drug adherence. However, the durability of different STRs was unknown in the real world settings. Our aim was to investigate the durability of different initial STR regimens in patients starting STR in southern Taiwan Method: This was a retrospective study of antiretroviral-naive patients that initiated first-line antiretroviral regimens with STRs between May 2016 and December 2017. The primary endpoint was time to virological failure (defined as plasma HIV RNAs≧200 copies/mL after 24 weeks). Secondary endpoints were STR discontinuation due to toxicity/intolerance. Survival analysis was done using Kaplan–Meier and Cox regression.Results: Two hundred and twenty-three patients were included: Over a median (IQR) of 86 (60-112) weeks, 25 patients (11%) experienced virological failure; the 1 year probability of virological failure was 11% (8/70) for Efavirenz/Emtricitabine/ Tenofovir Disoproxil Fumarate, 7% (4/54) for Emtricitabine/Rilpivirine/Tenofovir Disoproxil Fumarate and 13% (13/99) for Abacavir/Dolutegravir/Lamivudine. Fifty-six patients (25%) discontinued their STRs owing to toxicity/intolerance. When compared to Efavirenz/Emtricitabine/ Tenofovir Disoproxil Fumarate, treatment with Emtricitabine/Rilpivirine/Tenofovir Disoproxil Fumarate (AHR 8.39, CI 1.98-35.58, p=0.004) and Abacavir/Dolutegravir/Lamivudine (AHR 8.40, CI 2.39-29.54, p=0.001) were more likely to have treatment failure. However, when the risk of treatment failure was compared between two different STRs, treatment with Emtricitabine/Rilpivirine/Tenofovir Disoproxil Fumarate was not found to have higher risk of treatment failure when compared to Efavirenz/Emtricitabine/ Tenofovir Disoproxil Fumarate (log rank test p=0.116). The predictors for treatment failure included age≦30 years old (AHR 3.73, CI 1.25-11.17, p=0.018), switch between different STR (AHR 2.3, CI 1.18-4.50, p=0.001) and free of active syphilis infection (AHR 0.24, CI 0.08-0.73, p=0.012). The risk factor for treatment discontinuation included younger age≦30 years old (AHR 3.82, CI 1.21-12.37, p=0.023), treatment with Efavirenz/Emtricitabine/ Tenofovir Disoproxil Fumarate (AHR 8.65 , CI 2.64-28.39 , p<0.001) and free of active syphilis infection (AHR0.16, CI 0.04-0.62, p=0.006). Conclusion: Younger age was associated with treatment failure and drug discontinuation. Active syphilis infection s/p treatment was associated with free from treatment failure and discontinuation. This probably driven by the more frequently sexual health education and counseling when patients had syphilis infection. The STR durability was dependent on the drug toxicity/intolerance, age and syphilis infection

show abstract

Durability of different initial regimens in HIV-infected patients starting antiretroviral therapy with CD4+ counts <200 cells/mm3 and HIV-RNA >5 log10 copies/mL

Cited by 14 publications

References 23 publications

Efficacy and durability of two‐ vs. three‐drug integrase inhibitor‐based regimens in virologically suppressed HIV‐infected patients: Data from real‐life ODOACRE cohort

Efficacy and durability of two‐ vs. three‐drug integrase inhibitor‐based regimens in virologically suppressed HIV‐infected patients: Data from real‐life ODOACRE cohort

Durability of Single Tablet Regimen for Patients with HIV infection in Southern Taiwan: data from a real world setting

Durability of Single Tablet Regimen for Patients with HIV infection in Southern Taiwan: data from a real world setting

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