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Similar long-term efficacy of dual therapy containing raltegravir and a boosted protease inhibitor versus standard triple therapies in pretreated HIV-1-infected patients in a retrospective, real-life cohort of 14 years.
- Source :
-
HIV medicine [HIV Med] 2018 Oct; Vol. 19 (9), pp. 662-667. Date of Electronic Publication: 2018 Jul 03. - Publication Year :
- 2018
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Abstract
- Objectives: Raltegravir is used in many antiretroviral combinations, but its use in treatment-experienced patients without knowledge of baseline resistance is discussed controversially as a number of comparative studies have shown a higher rate of virological failure. However, it has been used frequently for the management of treatment failure, as it was the first integrase inhibitor to become available, and thus offered new options for patients with multiple resistance. The strategic use of raltegravir in this setting is examined in this study.<br />Methods: In order to examine the efficacy of raltegravir in second and later lines of antiretroviral combinations, data for 740 patients from three clinical cohorts were analysed with a focus on the combinations that were used. These were stratified into the combination of two nonnucleoside reverse transcriptase inhibitors and raltegravir (2NRTIs + RAL), the combination of a boosted protease inhibitor and raltegravir (bPI + RAL), and other raltegravir-containing combinations.<br />Results: The overall rate of virological suppression to < 50 HIV-1 RNA copies/mL was 69.5%. Although the baseline rate of virological suppression was higher for 2NRTIs + RAL than for the other strata, the outcomes were similar for all three groups at weeks 24, 48, 72 and 96.<br />Conclusions: These data indicate that, in a real-life setting, raltegravir can be used with a high virological success rate in treatment-experienced patients, and that the different combinations analysed (2NRTIs + RAL, bPI + RAL and others) show comparable rates of virological suppression.<br /> (© 2018 British HIV Association.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Female
HIV Infections virology
Humans
Male
Middle Aged
Prospective Studies
Protease Inhibitors pharmacology
Raltegravir Potassium pharmacology
Reverse Transcriptase Inhibitors pharmacology
Sustained Virologic Response
Treatment Outcome
Viral Load drug effects
Young Adult
HIV Infections drug therapy
HIV-1 drug effects
Protease Inhibitors administration & dosage
Raltegravir Potassium administration & dosage
Reverse Transcriptase Inhibitors administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1468-1293
- Volume :
- 19
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- HIV medicine
- Publication Type :
- Academic Journal
- Accession number :
- 29971922
- Full Text :
- https://doi.org/10.1111/hiv.12636