Outcomes of Heavily Experienced HIV-Infected Patients Receiving Salvage Raltegravir-Based Therapy

Abstract

Objectives To assess real-life virologic success, long-term survival, and adverse events in treatment-experienced patients initiating either raltegravir or other third-line drugs (darunavir/ritonavir, maraviroc or etravirine) for salvage regimens in a Brazilian cohort of heavily treated patients. Results We included 168 patients initiating salvage regimens, 123 on raltegravir and 45 on other drugs (darunavir/ritonavir, maraviroc or etravirine). Of these, 90 patients were matched by Propensity score (PS) methods to account for clinical differences at the time of the switch from failing ART regimens, 45 patients from each group. During follow-up, virologic suppression (PVL<50 copies/mL) was similar for both groups (77.8% vs. 82.2%, p=0.73). During a mean follow-up of 1.09 (SD = 0.32) years, mortality rates (4.04 vs 6.18 persons per 100 person-years; p=0.67), drug toxicity (0.00 vs 2.06 persons per 100 person-years; p=0.49), treatment interruption (8.07 vs 0.00 persons per 100 person-years; p=0.06), virologic failure (2.02 vs 4.12 persons per 100 person-years; p=0.61) and loss of follow-up (6.05 vs 4.12 persons per 100 person-years; p=0.70) were similar for both groups. Our findings suggest similar survival and virologic success rates for raltegravir and other drugs for salvage regimens, with similar drug toxicity rates, treatment interruption, virologic failure, and loss of follow-up.