Gagliardini, R;
Gianotti, N;
Maggiolo, F;
Cozzi-Lepri, A;
Antinori, A;
Nozza, S;
Lapadula, G;
... ICONA Foundation Study Group, .; + view all
(2021)
Durability of rilpivirine-based versus integrase inhibitor-based regimens in a large cohort of naïve HIV-infected patients starting antiretroviral therapy.
International Journal of Antimicrobial Agents
, 58
(4)
, Article 106406. 10.1016/j.ijantimicag.2021.106406.
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Cozzi-Lepri_Durability of rilpivirine- versus integrase inhibitor-based regimens in a large cohort of naïve HIV-infected patients starting antiretroviral therapy_AAM.pdf - Accepted Version Download (307kB) | Preview |
Abstract
OBJECTIVE: Comparisons between rilpivirine (RPV) and integrase strand transfer inhibitors (INSTIs) in antiretroviral therapy (ART)-naïve HIV-infected individuals are currently lacking. Aim of the study was to compare, in an observational cohort setting, the durability of treatment of RPV- and INSTI-based first-line regimens. METHODS: Patients who started first-line ARTs based on RPV or on INSTIs, with HIV-RNA <100,000 copies/mL, CD4 cells count >200 cells/μL, were included. The primary endpoint was the cumulative probability of treatment failure (TF = virological failure [confirmed HIV-RNA >50 copies/mL] or discontinuation of the anchor drug in the regimen), as assessed by Kaplan-Meier method. A multivariable Cox regression was used to control for potential confounding. RESULTS: Of 1991 patients included, 986 started ART with a RPV- and 1,005 with an INSTI-based regimen. The median (IQR) follow-up was 20 (10, 35) months. The cumulative two-years probability of TF with RPV (9.1% [95% 7.2, 11.1]) was lower than that observed in the INSTI group (16.6% [13.8, 19.4], p=0.0002) but not when comparing with dolutegravir (DTG) alone. Starting ART with an INSTIs-based regimen vs. RPV was associated with a higher risk of TF after controlling for potential confounding factors (AHR [95%CI]: 1.64 [1.28, 2.10]; p<0.001). Results were similar when restricting the analysis to STR regimens, although the probability of virological success was higher for INSTI and for DTG. CONCLUSIONS: In ART-naïve patients with low viral load and high CD4 count, the risk of treatment failure was lower in patients who started RPV- vs. INSTIs-based regimens other than DTG-based ones.
| Type: | Article |
|---|---|
| Title: | Durability of rilpivirine-based versus integrase inhibitor-based regimens in a large cohort of naïve HIV-infected patients starting antiretroviral therapy |
| Location: | Netherlands |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.ijantimicag.2021.106406 |
| Publisher version: | https://doi.org/10.1016/j.ijantimicag.2021.106406 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions. |
| Keywords: | antiretroviral naïve, dolutegravir, elvitegravir, raltegravir, rilpivirine, single tablet regimen |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10132584 |
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