Virological outcomes of various first-line ART regimens in patients harbouring HIV-1 E157Q integrase polymorphism: a multicentre retrospective study.
J Antimicrob Chemother
; 78(12): 2859-2868, 2023 12 01.
Article
em En
| MEDLINE
| ID: mdl-37856677
ABSTRACT
BACKGROUND:
Integrase strand transfer inhibitors (INSTIs) are recommended as first-line ART for people living with HIV (PLWH) in most guidelines. The INSTI-resistance-associated mutation E157Q, a highly prevalent (2%-5%) polymorphism of the HIV-1 (human immunodeficiency virus type 1) integrase gene, has limited data on optimal first-line ART regimens. We assessed the virological outcomes of various first-line ART regimens in PLWH with E157Q in real-world settings.METHODS:
A multicentre retrospective observational study was conducted on PLWH who underwent integrase genotypic drug-resistance testing before ART initiation between 2008 and 2019 and were found to have E157Q. Viral suppression (<50â copies/mL) rate at 24 and 48â weeks, time to viral suppression and time to viral rebound (≥100â copies/mL) were compared among the first-line ART regimens.RESULTS:
E157Q was detected in 167 (4.1%) of 4043 ART-naïve PLWH. Among them, 144 had available clinical data after ART initiation with a median follow-up of 1888â days. Forty-five started protease inhibitorsâ+â2 NRTIs (PI group), 33 started first-generation INSTI (raltegravir or elvitegravir/cobicistat)â+â2 NRTIs (INSTI-1 group), 58 started once-daily second-generation INSTI (dolutegravir or bictegravir)â+â2 NRTIs (INSTI-2 group) and eight started other regimens. In the multivariate analysis, the INSTI-2 group showed similar or favourable outcomes compared with the PI group for viral suppression rates, time to viral suppression and time to viral rebound. Two cases in the INSTI-1 group experienced virological failure.CONCLUSIONS:
The general guideline recommendation of second-generation INSTI-based first-line ART for most PLWH is also applicable to PLWH harbouring E157Q.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Infecções por HIV
/
HIV-1
/
Inibidores de Integrase de HIV
/
Integrase de HIV
Limite:
Humans
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article