Switching to Dolutegravir/lamivudine or Bictegravir/Emtricitabine/Tenofovir alafenamide. A comparative real-world study

IF 1.7 4区 医学 Q3 INFECTIOUS DISEASES HIV Research & Clinical Practice Pub Date : 2023-07-26 DOI:10.1080/25787489.2023.2239564
Hernando Knobel, Esperanza Cañas-Ruano, Ana Guelar, Pablo Knobel, Judit Villar-García, Alicia González-Mena, Ceclia Canepa, Itziar Arrieta-Aldea, Augustin Marcos, Agustí Abalat-Torrres, Roberto Güerri-Fernández
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Abstract

Background

This real-world study compared the safety and effectiveness of Dolutegravir/lamivudine (D/L) and Bictegravir/Emtricitabine/Tenefovir alafenamide (B/F/T) switch therapy regimens for people living with HIV (PLWH)

Methods

The retrospective study conducted from April 2019 to November 2022, included PLWH with < 50 copies/mL of HIV-RNA prior to recruitment who initiated either D/L or B/F/T switching therapy. The primary objective was to evaluate treatment discontinuation rates; safety and virologic outcomes were also evaluated.

Results

690 PLWH were included, 358 in the D/L and 332 in the B/F/T, and a median follow-up of 728 and 1013 days, respectively. The discontinuation proportions were 8.7% (31 participants, incidence rate of 4.44 per 100 PYFU in the D/L group and 15.3% (51 participants, incidence rate of 6.25 per 100 PYFU) in the B/F/T group. The adjusted hazard ratio for B/F/T discontinuation compared to D/L was 1.20 (95% CI: 0.71;2.0; p = 0.494). Virologic failure (VL > 200 copies/mL in two consecutive measurements) occurred in 1.1% and 0.9% of patients in the D/L and B/F/T groups, respectively. Notably, one patient in D/L group with severe non-adherence and virologic failure developed resistance mutations.

Conclusions

Switching to either B/T/F or D/L treatment for PLWH was effective and well tolerated in this real-world study. Treatment discontinuation rates did not significantly differ between the two regimens.

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改用多替格拉韦/拉米夫定或比替格拉韦/恩曲他滨/替诺福韦阿拉芬胺。一个比较现实世界的研究
本研究比较了多替格拉韦/拉米夫定(D/L)和比替格拉韦/恩曲他滨/替奈福韦拉米夫定(B/F/T)切换治疗方案对HIV感染者(PLWH)的安全性和有效性。方法回顾性研究于2019年4月至2022年11月进行。在招募前进行D/L或B/F/T转换治疗的HIV-RNA为50拷贝/mL。主要目的是评估治疗中断率;安全性和病毒学结果也进行了评估。结果共纳入690例PLWH, D/L组358例,B/F/T组332例,中位随访时间分别为728天和1013天。D/L组停药比例为8.7%(31例,发病率为4.44 / 100 PYFU), B/F/T组为15.3%(51例,发病率为6.25 / 100 PYFU)。与D/L相比,B/F/T停药的调整风险比为1.20 (95% CI: 0.71;2.0;p = 0.494)。病毒学失败(VL >在D/L组和B/F/T组中,分别有1.1%和0.9%的患者出现200拷贝/mL(连续两次测量)。值得注意的是,D/L组中有1例严重不依从性和病毒学失败的患者发生了耐药性突变。在这项现实世界的研究中,切换到B/T/F或D/L治疗PLWH是有效的,并且耐受性良好。两种治疗方案的停药率没有显著差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.90
自引率
6.20%
发文量
15
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