Rilpivirine use in the Swiss HIV cohort study: a prospective cohort study

BMC Infectious Diseases

Research Article

Angèle Gayet-Ageron¹  Patrick Schmid²  Manuel Battegay³  Jan Fehr⁴  Enos Bernasconi⁵  Delphine Sculier⁶  Alexandra Calmy⁶  Matthias Cavassini⁷  Cedric Hirzel⁸ 

[1] Clinical Research Center and Division of Clinical Epidemiology, Department of Health and Community Medicine, University Hospital Geneva, Geneva, Switzerland;Division of Infectious Diseases and Hospital Epidemiology, St. Gallen Cantonal Hospital, St. Gallen, Switzerland;Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland;Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland;Division of Infectious Diseases, Ospedale Regionale, Lugano, Switzerland;Division of Infectious Diseases, University Hospital Geneva, Geneva, Switzerland;Division of Infectious Diseases, University Hospital of Lausanne, Lausanne, Switzerland;University Clinic of Infectious Diseases, University Hospital Bern, Bern, Switzerland;

关键词: HIV-1;    Rilpivirine;    First-line regimen;    Treatment simplification;    Virological response;    Safety;   

DOI  :  10.1186/s12879-017-2579-2

 received in 2016-12-23, accepted in 2017-06-29,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundRilpivirine is safe and effective in HIV-naïve patients with low baseline HIV-RNA or in switch strategy. It offers the advantages of few drug-drug interactions and a favourable toxicity profile. We aimed to determine the reasons for prescribing the rilpivirine (RPV)/tenofovir disoproxil (TDF)/emtricitabine (FTC) co-formulation within the Swiss HIV Cohort Study and to assess its effectiveness and safety over a 24 months period.MethodsAll individuals enrolled in the Swiss HIV Cohort Study who initiated a RPV/TDF/FTC co-formulation between April 2013 and March 2014 were included. Primary outcomes were the HIV-RNA viral load (copies/mL) and CD4 cell count (cells/mm3) at 6, 12 and 24 months. Reasons for a switch to RPV/TDF/FTC were evaluated through a standardized questionnaire. We also assessed discontinuation and reasons for discontinuation of RPV/TDF/FTC until October 30, 2015.ResultsOf 644 individuals who started the RPV/TDF/FTC co-formulation, only 7.5% were treatment-naïve. At 24 months, viral suppression (HIV-RNA <50 copies/mL) was achieved in 100% and 96.7% of cART-naïve and cART-experienced patients respectively. The switch to RPV was mainly done for simplification (44.6%) and to overcome central nervous system toxicity symptoms due to efavirenz (24%). Six months after switch, 74.8% of patients reported an improvement of psycho-neurological symptoms with continued improvement at 12 months for almost 80%. However, one quarter of patients reported a discontinuation of RPV/TDF/FTC on October 30, 2015 after a median time of 18.4 months. Reasons for discontinuation included physician decision (5.3%) and side-effects (3.9%) mainly related to the central nervous system and to renal toxicity.ConclusionThe RPV/TDF/FTC co-formulation was safe and effective throughout 24 months of follow-up but barely prescribed for HIV-naïve patients. Despite excellent virological suppression among both treatment-naïve and -experienced patients, we observed a high rate of treatment discontinuation.

【 授权许可】

CC BY   
© The Author(s). 2017