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Switch as maintenance to elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate: week 48 results in a clinical cohort.
- Source :
-
The Journal of antimicrobial chemotherapy [J Antimicrob Chemother] 2017 Jun 01; Vol. 72 (6), pp. 1745-1751. - Publication Year :
- 2017
-
Abstract
- Objectives: To assess, in a clinical cohort, the efficacy of switching current ART in virologically suppressed patients to elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate as a single-tablet regimen (STR) using the PCR signal of the plasma viral load (pVL) assay and determination of plasma drug concentration ( C 24 ).<br />Patients and Methods: This was an observational single-centre study enrolling antiretroviral-treated patients with pVL <50 copies/mL initiating elvitegravir-based STR. PCRneg was defined as an undetected PCR signal.<br />Results: One hundred and fifty-one patients were enrolled. At STR baseline, the median time since first ART and time of virological suppression were 5 years (IQR 3-9) and 24 months (IQR 9-44), respectively. By week (W) 48, 26 (17%) of the patients had discontinued STR due to adverse events. The proportion of patients maintaining pVL <50 copies/mL on treatment was 98%, 96%, 93% and 97% at W12, W24, W36 and W48, respectively. Five patients (3.3%) experienced a virological failure and emergence of resistance was observed in two of them with the selection of M184V and N155H mutations. At baseline, W12, W24, W36 and W48, 70%, 57%, 72%, 61% and 74% of the patients with pVL <20 copies/mL had a PCRneg, respectively. The median elvitegravir plasma C 24 value was 648 ng/mL (IQR 348-989; n = 237), with 84% of elvitegravir C 24 values >45 ng/mL, the protein-adjusted IC 95 .<br />Conclusions: In this clinical cohort of virologically suppressed patients switching to STR, most subjects had adequate elvitegravir C 24 values with a high proportion maintaining virological suppression with no residual viraemia until W48.<br /> (© The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)
- Subjects :
- Adult
Anti-HIV Agents administration & dosage
Anti-HIV Agents blood
Anti-HIV Agents therapeutic use
Antiretroviral Therapy, Highly Active
CD4 Lymphocyte Count
Cobicistat administration & dosage
Cobicistat blood
Cohort Studies
Emtricitabine administration & dosage
Emtricitabine blood
Female
HIV Infections blood
HIV-1 drug effects
Humans
Maintenance Chemotherapy
Male
Middle Aged
Polymerase Chain Reaction
Quinolones administration & dosage
Quinolones blood
RNA, Viral blood
Tablets
Tenofovir administration & dosage
Tenofovir blood
Viremia drug therapy
Cobicistat therapeutic use
Emtricitabine therapeutic use
HIV Infections drug therapy
Quinolones therapeutic use
Tenofovir therapeutic use
Viral Load
Subjects
Details
- Language :
- English
- ISSN :
- 1460-2091
- Volume :
- 72
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- The Journal of antimicrobial chemotherapy
- Publication Type :
- Academic Journal
- Accession number :
- 28186251
- Full Text :
- https://doi.org/10.1093/jac/dkx018