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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | 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. |
| Related Links | https://aidsrestherapy.biomedcentral.com/counter/pdf/10.1186/s12981-022-00499-4.pdf |
| Ending Page | 10 |
| Page Count | 10 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 17426405 |
| DOI | 10.1186/s12981-022-00499-4 |
| Journal | AIDS Research and Therapy |
| Issue Number | 1 |
| Volume Number | 20 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2023-01-03 |
| Access Restriction | Open |
| Subject Keyword | Infectious Diseases Virology E/C/F/TDF switch virologic efficacy integrase resistance |
| Content Type | Text |
| Resource Type | Article |
| Subject | Molecular Medicine Virology Pharmacology (medical) |
| Journal Impact Factor | 2.1/2023 |
| 5-Year Journal Impact Factor | 2.4/2023 |
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