Switching to Dolutegravir/lamivudine or Bictegravir/Emtricitabine/Tenofovir alafenamide. A comparative real-world study
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, in...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2023-12-01
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| Series: | HIV Research & Clinical Practice |
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| Online Access: | http://dx.doi.org/10.1080/25787489.2023.2239564 |
| _version_ | 1826862242233057280 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Hernando Knobel |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-08T23:47:46Z |
| format | Article |
| id | doaj.art-8bd4cbdc05564a438f6ad7794e4d765a |
| institution | Directory Open Access Journal |
| issn | 2578-7470 |
| language | English |
| last_indexed | 2025-02-16T20:36:50Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | HIV Research & Clinical Practice |
| spelling | doaj.art-8bd4cbdc05564a438f6ad7794e4d765a2025-01-20T14:37:59ZengTaylor & Francis GroupHIV Research & Clinical Practice2578-74702023-12-0124110.1080/25787489.2023.22395642239564Switching to Dolutegravir/lamivudine or Bictegravir/Emtricitabine/Tenofovir alafenamide. A comparative real-world studyHernando Knobel0Esperanza Cañas-Ruano1Ana Guelar2Pablo Knobel3Judit Villar-García4Alicia González-Mena5Ceclia Canepa6Itziar Arrieta-Aldea7Augustin Marcos8Agustí Abalat-Torrres9Roberto Güerri-Fernández10Department of Infectious Diseases, Hospital del MarDepartment of Infectious Diseases, Hospital del MarDepartment of Infectious Diseases, Hospital del MarDepartment of Environmental Medicine and Public Health, Icahn School of Medicine at Mount SinaiDepartment of Infectious Diseases, Hospital del MarDepartment of Infectious Diseases, Hospital del MarDepartment of Infectious Diseases, Hospital del MarDepartment of Infectious Diseases, Hospital del MarDepartment of Infectious Diseases, Hospital del MarDepartment of Pharmacy, Hospital del MarDepartment of Infectious Diseases, Hospital del MarBackground 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.http://dx.doi.org/10.1080/25787489.2023.2239564switching antiretroviral therapyoptimizing antiretroviral therapydolutegravir/lamivudinebictegravir/emtricitabine/tenofovir alafenamidereal-world data |
| spellingShingle | 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 Switching to Dolutegravir/lamivudine or Bictegravir/Emtricitabine/Tenofovir alafenamide. A comparative real-world study HIV Research & Clinical Practice switching antiretroviral therapy optimizing antiretroviral therapy dolutegravir/lamivudine bictegravir/emtricitabine/tenofovir alafenamide real-world data |
| title | Switching to Dolutegravir/lamivudine or Bictegravir/Emtricitabine/Tenofovir alafenamide. A comparative real-world study |
| title_full | Switching to Dolutegravir/lamivudine or Bictegravir/Emtricitabine/Tenofovir alafenamide. A comparative real-world study |
| title_fullStr | Switching to Dolutegravir/lamivudine or Bictegravir/Emtricitabine/Tenofovir alafenamide. A comparative real-world study |
| title_full_unstemmed | Switching to Dolutegravir/lamivudine or Bictegravir/Emtricitabine/Tenofovir alafenamide. A comparative real-world study |
| title_short | Switching to Dolutegravir/lamivudine or Bictegravir/Emtricitabine/Tenofovir alafenamide. A comparative real-world study |
| title_sort | switching to dolutegravir lamivudine or bictegravir emtricitabine tenofovir alafenamide a comparative real world study |
| topic | switching antiretroviral therapy optimizing antiretroviral therapy dolutegravir/lamivudine bictegravir/emtricitabine/tenofovir alafenamide real-world data |
| url | http://dx.doi.org/10.1080/25787489.2023.2239564 |
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