Effectiveness of integrase strand transfer inhibitors in HIV-infected treatment-experienced individuals across Europe.
HIV Med
; 23(7): 774-789, 2022 08.
Article
em En
| MEDLINE
| ID: mdl-35199909
ABSTRACT
OBJECTIVES:
To explore the effectiveness and durability of integrase strand transfer inhibitor (INSTI)-based regimens in pre-treated subjects.METHODS:
Treatment-experienced individuals starting an INSTI-based regimen during 2012-2019 were selected from the INTEGRATE collaborative study. The time to virological failure [VF one measurement of viral load (VL) ≥ 1000 copies/mL or two ≥ 50 copies/ml or one VL measurement ≥ 50 copies/mL followed by treatment change] and to INSTI discontinuation were evaluated.RESULTS:
Of 13 560 treatments analysed, 4284 were from INSTI-naïve, non-viraemic (IN-NV) individuals, 1465 were from INSTI-naïve, viraemic (IN-V) individuals, 6016 were from INSTI-experienced, non-viraemic (IE-NV) individuals and 1795 were from INSTI-experienced, viraemic (IE-V) individuals. Major INSTI drug resistance mutations (DRMs) were previously detected in 4/519 (0.8%) IN-NV, 3/394 (0.8%) IN-V, 7/1510 (0.5%) IE-NV and 25/935 (2.7%) IE-V individuals. The 1-year estimated probabilities of VF were 3.1% [95% confidence interval (CI) 2.5-3.8] in IN-NV, 18.4% (95% CI 15.8-21.2) in IN-V, 4.2% (95% CI 3.6-4.9) in IE-NV and 23.9% (95% CI 20.9-26.9) in IE-V subjects. The 1-year estimated probabilities of INSTI discontinuation were 12.1% (95% CI 11.1-13.0) in IN-NV, 19.6% (95% CI 17.5-21.6) in IN-V, 10.8% (95% CI 10.0-11.6) in IE-NV and 21.7% (95% CI 19.7-23.5) in IE-V subjects.CONCLUSIONS:
Both VF and INSTI discontinuation occur at substantial rates in viraemic subjects. Detection of DRMs in a proportion of INSTI-experienced individuals makes INSTI resistance testing mandatory after failure.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Infecções por HIV
/
Inibidores de Integrase de HIV
/
Integrase de HIV
Limite:
Humans
País/Região como assunto:
Europa
Idioma:
En
Revista:
HIV Med
Assunto da revista:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Itália