Incidence of low-level viremia and its impact on virologic failure among people living with HIV-1 who switched to elvitegravir-based antiretroviral therapy
ABSTRACT: Objectives: We aimed to investigate the incidence of low-level viremia (LLV) and its impact on virologic failure (VF) in people living with HIV (PLWH) on stable antiretroviral therapy (ART) who switched to co-formulated elvitegravir, cobicistat, emtricitabine and tenofovir alafenamide (EV...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-06-01
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| Series: | Journal of Global Antimicrobial Resistance |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S221371652200039X |
| _version_ | 1811242615880810496 |
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| author | Jen-Yu Hsu Hsin-Yun Sun Tan-Wen Hsieh Sui-Yuan Chang Yu-Chung Chuang Yu-Shan Huang Ching-Yu Hsiao Yi-Ching Su Wen-Chun Liu Shu-Fang Chang Chien-Ching Hung |
| author_facet | Jen-Yu Hsu Hsin-Yun Sun Tan-Wen Hsieh Sui-Yuan Chang Yu-Chung Chuang Yu-Shan Huang Ching-Yu Hsiao Yi-Ching Su Wen-Chun Liu Shu-Fang Chang Chien-Ching Hung |
| author_sort | Jen-Yu Hsu |
| collection | DOAJ |
| description | ABSTRACT: Objectives: We aimed to investigate the incidence of low-level viremia (LLV) and its impact on virologic failure (VF) in people living with HIV (PLWH) on stable antiretroviral therapy (ART) who switched to co-formulated elvitegravir, cobicistat, emtricitabine and tenofovir alafenamide (EVG/c/FTC/TAF). Methods: PLWH aged 18 years or older who had received ART with plasma HIV RNA load (PVL) <50 copies/mL for 6 months or longer and switched to EVG/c/FTC/TAF between March and October 2018 were retrospectively included. The incidence of LLV (defined as PVL of 50–999 copies/mL) and VF (PVL ≥1000 copies/mL) was calculated and represented by Kaplan-Meier plots. The generalised estimating equation model was constructed to identify factors associated with LLV and VF. Resistance-associated mutations were determined using population sequencing. Results: A total of 1078 PLWH were included. The incidence rates of LLV and VF after the switch to EVG/c/FTC/TAF were 3.5 and 0.8 events per 100 person-years of follow-up, respectively, whereas the respective cumulative incidence of LLV and VF reached 11.7% and 2.9% within 3 years of follow-up. LLV was associated with any LLV episode before or after the switch and prior exposure to integrase strand transfer inhibitor-based ART. VF was associated with any LLV before or after the switch and prior exposure to raltegravir, but not the level or frequency of LLV. Conclusion: The risks of LLV and VF were low in PLWH who had achieved virologic suppression and switched to EVG/c/FTC/TAF, and the presence of LLV and prior exposure to raltegravir increased the risk of VF. |
| first_indexed | 2024-04-12T13:53:41Z |
| format | Article |
| id | doaj.art-16f038fd57c847a5b81d827608d0ba7e |
| institution | Directory Open Access Journal |
| issn | 2213-7165 |
| language | English |
| last_indexed | 2024-04-12T13:53:41Z |
| publishDate | 2022-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Global Antimicrobial Resistance |
| spelling | doaj.art-16f038fd57c847a5b81d827608d0ba7e2022-12-22T03:30:26ZengElsevierJournal of Global Antimicrobial Resistance2213-71652022-06-0129716Incidence of low-level viremia and its impact on virologic failure among people living with HIV-1 who switched to elvitegravir-based antiretroviral therapyJen-Yu Hsu0Hsin-Yun Sun1Tan-Wen Hsieh2Sui-Yuan Chang3Yu-Chung Chuang4Yu-Shan Huang5Ching-Yu Hsiao6Yi-Ching Su7Wen-Chun Liu8Shu-Fang Chang9Chien-Ching Hung10Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanInstitute of Public Health, College of Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanDepartment of Laboratory Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department of Tropical Medicine and Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung, Taiwan; China Medical University, Taichung, Taiwan; Corresponding author. C.-C. Hung. Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei City 100, Taiwan.ABSTRACT: Objectives: We aimed to investigate the incidence of low-level viremia (LLV) and its impact on virologic failure (VF) in people living with HIV (PLWH) on stable antiretroviral therapy (ART) who switched to co-formulated elvitegravir, cobicistat, emtricitabine and tenofovir alafenamide (EVG/c/FTC/TAF). Methods: PLWH aged 18 years or older who had received ART with plasma HIV RNA load (PVL) <50 copies/mL for 6 months or longer and switched to EVG/c/FTC/TAF between March and October 2018 were retrospectively included. The incidence of LLV (defined as PVL of 50–999 copies/mL) and VF (PVL ≥1000 copies/mL) was calculated and represented by Kaplan-Meier plots. The generalised estimating equation model was constructed to identify factors associated with LLV and VF. Resistance-associated mutations were determined using population sequencing. Results: A total of 1078 PLWH were included. The incidence rates of LLV and VF after the switch to EVG/c/FTC/TAF were 3.5 and 0.8 events per 100 person-years of follow-up, respectively, whereas the respective cumulative incidence of LLV and VF reached 11.7% and 2.9% within 3 years of follow-up. LLV was associated with any LLV episode before or after the switch and prior exposure to integrase strand transfer inhibitor-based ART. VF was associated with any LLV before or after the switch and prior exposure to raltegravir, but not the level or frequency of LLV. Conclusion: The risks of LLV and VF were low in PLWH who had achieved virologic suppression and switched to EVG/c/FTC/TAF, and the presence of LLV and prior exposure to raltegravir increased the risk of VF.http://www.sciencedirect.com/science/article/pii/S221371652200039XIntegrase strand transfer inhibitorPlasma HIV RNA loadVirologic responseViral blipResistance-associated mutation |
| spellingShingle | Jen-Yu Hsu Hsin-Yun Sun Tan-Wen Hsieh Sui-Yuan Chang Yu-Chung Chuang Yu-Shan Huang Ching-Yu Hsiao Yi-Ching Su Wen-Chun Liu Shu-Fang Chang Chien-Ching Hung Incidence of low-level viremia and its impact on virologic failure among people living with HIV-1 who switched to elvitegravir-based antiretroviral therapy Journal of Global Antimicrobial Resistance Integrase strand transfer inhibitor Plasma HIV RNA load Virologic response Viral blip Resistance-associated mutation |
| title | Incidence of low-level viremia and its impact on virologic failure among people living with HIV-1 who switched to elvitegravir-based antiretroviral therapy |
| title_full | Incidence of low-level viremia and its impact on virologic failure among people living with HIV-1 who switched to elvitegravir-based antiretroviral therapy |
| title_fullStr | Incidence of low-level viremia and its impact on virologic failure among people living with HIV-1 who switched to elvitegravir-based antiretroviral therapy |
| title_full_unstemmed | Incidence of low-level viremia and its impact on virologic failure among people living with HIV-1 who switched to elvitegravir-based antiretroviral therapy |
| title_short | Incidence of low-level viremia and its impact on virologic failure among people living with HIV-1 who switched to elvitegravir-based antiretroviral therapy |
| title_sort | incidence of low level viremia and its impact on virologic failure among people living with hiv 1 who switched to elvitegravir based antiretroviral therapy |
| topic | Integrase strand transfer inhibitor Plasma HIV RNA load Virologic response Viral blip Resistance-associated mutation |
| url | http://www.sciencedirect.com/science/article/pii/S221371652200039X |
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