Effectiveness of the combination elvitegravir/cobicistat/tenofovir/emtricitabine (EVG/COB/TFV/FTC) plus darunavir among treatment-experienced patients in clinical practice: A multicentre cohort study

Background: The aim of this study was to investigate the effectiveness and tolerability of the combination elvitegra vir/cobicistat/tenofovir/emtricitabine plus darunavir (EVG/COB/TFV/FTC + DRV) in treatment experienced patients from the cohort of the Spanish HIV/AIDS Research Network (CoRIS). Metho...

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Detalles Bibliográficos
Autores: López Cortés, Luis Fernando, Macías Sánchez, Juan, Merchante Gutiérrez, Nicolás, Real Navarrete, Luis Miguel, González-Serna Martín, Manuel Alejandro, Suárez-García, Inés, Moreno, Cristina, Ruiz-Algueró, Marta, Pérez-Elías, María Jesús, Navarro, Marta, Díez Martínez, Marcos
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Institución:Universidad de Sevilla (US)
Repositorio:idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:oai:idus.us.es:11441/177018
Acceso en línea:https://hdl.handle.net/11441/177018
https://doi.org/10.1186/s12981‑020‑00302‑2
Access Level:acceso abierto
Palabra clave:HIV infection
Highly active antiretroviral therapy
Cohort studies
Darunavir
Descripción
Sumario:Background: The aim of this study was to investigate the effectiveness and tolerability of the combination elvitegra vir/cobicistat/tenofovir/emtricitabine plus darunavir (EVG/COB/TFV/FTC + DRV) in treatment experienced patients from the cohort of the Spanish HIV/AIDS Research Network (CoRIS). Methods: Treatment experienced patients starting treatment with EVG/COB/TFV/FTC + DRV during the years 2014–2018 and with more than 24 weeks of follow up were included. TFV could be administered either as tenofovir disoproxil fumarate or tenofovir alafenamide. We evaluated virological response, defined as viral load (VL) < 50 copies/ ml and < 200 copies/ml at 24 and 48 weeks after starting this regimen, stratified by baseline VL (< 50 or ≥ 50 copies/ml at the start of the regimen). Results: We included 39 patients (12.8% women). At baseline, 10 (25.6%) patients had VL < 50 copies/ml and 29 (74.4%) had ≥ 50 copies/ml. Among patients with baseline VL < 50 copies/ml, 85.7% and 80.0% had VL < 50 copies/ml at 24 and 48 weeks, respectively, and 100% had VL < 200 copies/ml at 24 and 48 weeks. Among patients with baseline VL ≥ 50 copies/ml, 42.3% and 40.9% had VL < 50 copies/ml and 69.2% and 68.2% had VL < 200 copies/ml at 24 and 48 weeks. During the first 48 weeks, no patients changed their treatment due to toxicity, and 4 patients (all with base line VL ≥ 50 copies/ml) changed due to virological failure. Conclusions: EVG/COB/TFV/FTC + DRV was well tolerated and effective in treatment experienced patients with undetectable viral load as a simplification strategy, allowing once daily, two pill regimen with three antiretroviral drug classes. Effectiveness was low in patients with detectable viral loads.