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Pujari S, Gaikwad S, Panchawagh S, Chitalikar A, Joshi K, Rohekar C, Dabhade D, Bele V. Effectiveness, Weight Changes, and Metabolic Outcomes on Switch to Generic Dolutegravir/Lamivudine Among People with HIV in Western India: An Observational Study. AIDS Res Hum Retroviruses 2024; 40:204-215. [PMID: 38063004 DOI: 10.1089/aid.2022.0167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2024] Open
Abstract
We assessed the effectiveness and safety of switching to generic dolutegravir/lamivudine (DTG/3TC) among People living with Human Immunodeficiency Virus (PWH) in Western India. In this single-center, retrospective observational study, PWH, who switched to DTG/3TC, were followed for virologic, immunologic, and clinical effectiveness, and safety, including weight changes, hyperglycemia, and dyslipidemia. Multivariate linear mixed-effects models were used to predict average change in weight adjusted for age, sex, duration of previous antiretroviral (ARV) regimens, and baseline weight. From May 2017 to July 2022, out of 434 PWH switched to DTG/3TC, 304 with at least 1 follow-up visit were included. Median [interquartile range (IQR)] age was 54 (IQR 49-61) years and 70.1% were male. Prevalence of baseline comorbidities was 57.9% (hypertension-41.5%, chronic kidney disease-40.9%, and diabetes mellitus-18.8%). Reasons for switch were affordability (47.4%), desire for simplification (41.8%), ARV toxicities (19.1%), and concern about potential toxicities (10.2%). Median (IQR) duration of follow-up on DTG/3TC was 40 (IQR 31-49) weeks. No virologic failure was observed. Rates of virologic suppression [viral load (VL) ≤20 copies/mL or target not detected (TND)] at 12, 24, 48, 72, 96 and 120 weeks were 95.2%, 95.9%, 90%, 100%, 81.3%, and 88.4%, respectively. Only 9 (3%) PWH permanently discontinued DTG/3TC. Predicted adjusted mean weight gain of +3.3 kg was observed at 96 weeks. Switching from tenofovir disoproxil fumarate (TDF)/emtricitabine or lamivudine (XTC)/non-nucleoside reverse transcriptase inhibitor (NNRTI) and duration on DTG/3TC were significantly associated with weight gain. Apart from trend in worsening hyperglycemia (nine PWH with new onset diabetes), no clinically significant change in lipids and estimated glomerular filtration rate (eGFR) was documented. Switching to DTG/3TC is an effective and safe option among virologically suppressed PWH with high comorbidity burden in India. In view of the several advantages of DTG/3TC, it may be considered for potential scale-up in the right population, both in private and public health care settings in India.
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Affiliation(s)
| | | | | | | | - Kedar Joshi
- Institute of Infectious Diseases, Pune, India
| | | | | | - Vivek Bele
- Institute of Infectious Diseases, Pune, India
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Benson P, Kuretski J, Donovan C, Harper G, Merrill D, Metzner AA, Mycock K, Wallis H, Brogan AP, Patarroyo J, Oglesby A. Real-World Effectiveness of Dolutegravir/Lamivudine in People With HIV-1 in Test-and-Treat Settings or With High Baseline Viral Loads: TANDEM Study Subgroup Analyses. Infect Dis Ther 2024; 13:875-889. [PMID: 38570444 PMCID: PMC11058154 DOI: 10.1007/s40121-024-00950-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/22/2024] [Indexed: 04/05/2024] Open
Abstract
INTRODUCTION Dolutegravir/lamivudine (DTG/3TC) was first approved by the US Food and Drug Administration in 2019 for the treatment of antiretroviral therapy (ART)-naive people with HIV-1 based on results from the pivotal GEMINI-1/GEMINI-2 trials. Around that time, immediate initiation of treatment upon diagnosis was recommended in the US Department of Health and Human Services guidelines. Here we report results from 126 treatment-naive people with HIV-1 who initiated DTG/3TC as part of a test-and-treat strategy (n = 61) or with high baseline viral loads (HIV-1 RNA ≥ 100,000 copies/ml; n = 16) from the TANDEM study. METHODS TANDEM was a US-based, retrospective chart review study that included a cohort of 126 individuals aged ≥ 18 years with no prior history of ART who initiated DTG/3TC before September 30, 2020, and had ≥ 6 months of follow-up. Test-and-treat was defined as ART initiation shortly after diagnosis without available viral load, CD4 + cell count, or HIV-1 resistance data. Outcomes included virologic suppression (HIV-1 RNA < 50 copies/ml; overall and by baseline viral load) and discontinuations. Analyses were descriptive. RESULTS Among 61 individuals who initiated DTG/3TC in a test-and-treat setting (median [interquartile range (IQR)] treatment duration, 1.3 [0.9-1.7] years), 57 (93%) achieved virologic suppression, and 51 (84%) remained suppressed; 1 (< 1%) individual discontinued DTG/3TC due to persistent low-level viremia. The most common healthcare provider (HCP)-reported reason for initiating DTG/3TC was avoidance of long-term toxicities among individuals in the test-and-treat subgroup. Of 16 treatment-naive individuals with high baseline viral loads (median [IQR] treatment duration, 100,000-250,000 copies/ml: 1.2 [0.8-1.8] years; > 250,000 copies/ml: 1.0 [0.7-1.1] years), 14 (88%) achieved virologic suppression, 13 (81%) remained suppressed, and none discontinued DTG/3TC. Patient preference was the most common HCP-reported reason for initiating DTG/3TC in this subgroup. CONCLUSIONS Results demonstrate real-world effectiveness of DTG/3TC, with few discontinuations, in people with HIV-1 in test-and-treat settings or with high baseline viral loads.
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Affiliation(s)
- Paul Benson
- Be Well Medical Center, 1964 W Eleven Mile Road, Berkley, MI, 48072, USA
| | - Jennifer Kuretski
- Midway Specialty Care Center, 1515 N Flagler Drive, Suite 200, West Palm Beach, FL, 33401, USA
| | - Cynthia Donovan
- ViiV Healthcare, 406 Blackwell Street, Suite 300, Durham, NC, 27701, USA
| | - Gavin Harper
- Adelphi Real World, Adelphi Mill, Grimshaw Lane, Bollington, Macclesfield, SK10 5JB, UK
| | - Deanna Merrill
- ViiV Healthcare, 406 Blackwell Street, Suite 300, Durham, NC, 27701, USA
| | - Aimee A Metzner
- ViiV Healthcare, 406 Blackwell Street, Suite 300, Durham, NC, 27701, USA.
| | - Katie Mycock
- Adelphi Real World, Adelphi Mill, Grimshaw Lane, Bollington, Macclesfield, SK10 5JB, UK
| | - Hannah Wallis
- Adelphi Real World, Adelphi Mill, Grimshaw Lane, Bollington, Macclesfield, SK10 5JB, UK
| | - Andrew P Brogan
- ViiV Healthcare, 406 Blackwell Street, Suite 300, Durham, NC, 27701, USA
| | - Jimena Patarroyo
- ViiV Healthcare, 406 Blackwell Street, Suite 300, Durham, NC, 27701, USA
| | - Alan Oglesby
- ViiV Healthcare, 406 Blackwell Street, Suite 300, Durham, NC, 27701, USA
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Schneider S, Blick G, Burke C, Ward D, Benson P, Felizarta F, Green D, Donovan C, Harper G, Merrill D, Metzner AA, Mycock K, Wallis H, Patarroyo J, Brogan AP, Oglesby A. Two-Drug Regimens Dolutegravir/Lamivudine and Dolutegravir/Rilpivirine Are Effective with Few Discontinuations in US Real-World Settings: Results from the TANDEM Study. Infect Dis Ther 2024; 13:891-906. [PMID: 38570443 PMCID: PMC11058742 DOI: 10.1007/s40121-024-00961-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/12/2024] [Indexed: 04/05/2024] Open
Abstract
INTRODUCTION Dolutegravir/lamivudine (DTG/3TC) and dolutegravir/rilpivirine (DTG/RPV) are fixed-dose, complete, single-tablet, two-drug regimens (2DRs) indicated for HIV-1. DTG/3TC is approved for antiretroviral therapy (ART)-naive people with HIV-1 and virologically suppressed individuals to replace current ART; DTG/RPV is indicated for virologically suppressed individuals as a switch option. Virologic efficacy and effectiveness of these DTG-based 2DRs have been demonstrated in phase 3 clinical trials and real-world cohorts, primarily from Europe. This study characterized real-world use of DTG-based 2DRs for HIV-1 treatment in the USA. METHODS TANDEM was a retrospective medical chart review across 24 US sites. Individuals aged ≥ 18 years who initiated DTG/3TC or DTG/RPV before September 30, 2020, with ≥ 6 months of follow-up were included. One cohort included ART-naive people who initiated DTG/3TC (n = 126), and two other cohorts included virologically suppressed (HIV-1 RNA < 50 copies/mL) people on stable ART regimens for ≥ 3 months before switch to either DTG/3TC (n = 192) or DTG/RPV (n = 151). Clinical characteristics, treatment history, and outcomes are described. RESULTS Virologically suppressed individuals were older than those who were ART-naive, and the ART-naive cohort had higher proportions of individuals assigned male at birth and of Hispanic ethnicity. The most common healthcare provider-reported reason for choosing a DTG-based 2DR was avoidance of long-term toxicities (25-33% across cohorts), followed by simplification/streamlining of treatment. Among ART-naive people on DTG/3TC, 94% achieved virologic suppression after initiation, and 83% maintained suppression at last follow-up; discontinuation rate was < 1%. Among cohorts who switched to DTG-based 2DRs, 96% maintained virologic suppression on DTG/3TC and 93% on DTG/RPV; 2% on DTG/3TC and 3% on DTG/RPV discontinued. CONCLUSION Motivation for selecting DTG-based 2DRs was primarily driven by a desire to avoid or manage toxicities and simplify treatment. Results demonstrate that DTG/3TC and DTG/RPV are effective in real-world settings, with few discontinuations, reflecting data from clinical trials.
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Affiliation(s)
- Stefan Schneider
- Long Beach Education and Research Consultants, 1040 Elm Avenue, #303, Long Beach, CA, 90813, USA
| | - Gary Blick
- Health Care Advocates International, 2595 Main Street, 2nd Floor, Stratford, CT, 06615, USA
| | - Christina Burke
- CAN Community Health, 3251 3rd Avenue N, St Petersburg, FL, 33713, USA
| | - Douglas Ward
- Dupont Circle Physicians Group, 1145 19th Street NW, Suite 200, Washington, DC, 20009, USA
| | - Paul Benson
- Be Well Medical Center, 1964 W Eleven Mile Road, Berkley, MI, 48072, USA
| | - Franco Felizarta
- Bakersfield Family Medical Center, 4580 California Avenue, Bakersfield, CA, 93309, USA
| | - Dallas Green
- AHF Healthcare Center-Kinder, 3661 S Miami Avenue, Suite 806, Miami, FL, 33133, USA
| | - Cynthia Donovan
- ViiV Healthcare, 406 Blackwell Street, Suite 300, Durham, NC, 27701, USA
| | - Gavin Harper
- Adelphi Real World, Adelphi Mill, Grimshaw Lane, Bollington, Macclesfield, SK10 5JB, UK
| | - Deanna Merrill
- ViiV Healthcare, 406 Blackwell Street, Suite 300, Durham, NC, 27701, USA
| | - Aimee A Metzner
- ViiV Healthcare, 406 Blackwell Street, Suite 300, Durham, NC, 27701, USA
| | - Katie Mycock
- Adelphi Real World, Adelphi Mill, Grimshaw Lane, Bollington, Macclesfield, SK10 5JB, UK
| | - Hannah Wallis
- Adelphi Real World, Adelphi Mill, Grimshaw Lane, Bollington, Macclesfield, SK10 5JB, UK
| | - Jimena Patarroyo
- ViiV Healthcare, 406 Blackwell Street, Suite 300, Durham, NC, 27701, USA
| | - Andrew P Brogan
- ViiV Healthcare, 406 Blackwell Street, Suite 300, Durham, NC, 27701, USA
| | - Alan Oglesby
- ViiV Healthcare, 406 Blackwell Street, Suite 300, Durham, NC, 27701, USA.
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Chu C, Tao K, Kouamou V, Avalos A, Scott J, Grant PM, Rhee SY, McCluskey SM, Jordan MR, Morgan RL, Shafer RW. Prevalence of Emergent Dolutegravir Resistance Mutations in People Living with HIV: A Rapid Scoping Review. Viruses 2024; 16:399. [PMID: 38543764 PMCID: PMC10975848 DOI: 10.3390/v16030399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/27/2024] [Accepted: 02/28/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Dolutegravir (DTG) is a cornerstone of global antiretroviral (ARV) therapy (ART) due to its high efficacy and favorable tolerability. However, limited data exist regarding the risk of emergent integrase strand transfer inhibitor (INSTI) drug-resistance mutations (DRMs) in individuals receiving DTG-containing ART. METHODS We performed a PubMed search using the term "Dolutegravir", last updated 18 December 2023, to estimate the prevalence of VF with emergent INSTI DRMs in people living with HIV (PLWH) without previous VF on an INSTI who received DTG-containing ART. RESULTS Of 2131 retrieved records, 43 clinical trials, 39 cohorts, and 6 cross-sectional studies provided data across 6 clinical scenarios based on ART history, virological status, and co-administered ARVs: (1) ART-naïve PLWH receiving DTG plus two NRTIs; (2) ART-naïve PLWH receiving DTG plus lamivudine; (3) ART-experienced PLWH with VF on a previous regimen receiving DTG plus two NRTIs; (4) ART-experienced PLWH with virological suppression receiving DTG plus two NRTIs; (5) ART-experienced PLWH with virological suppression receiving DTG and a second ARV; and (6) ART-experienced PLWH with virological suppression receiving DTG monotherapy. The median proportion of PLWH in clinical trials with emergent INSTI DRMs was 1.5% for scenario 3 and 3.4% for scenario 6. In the remaining four trial scenarios, VF prevalence with emergent INSTI DRMs was ≤0.1%. Data from cohort studies minimally influenced prevalence estimates from clinical trials, whereas cross-sectional studies yielded prevalence data lacking denominator details. CONCLUSIONS In clinical trials, the prevalence of VF with emergent INSTI DRMs in PLWH receiving DTG-containing regimens has been low. Novel approaches are required to assess VF prevalence with emergent INSTI DRMs in PLWH receiving DTG in real-world settings.
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Affiliation(s)
- Carolyn Chu
- Department of Family and Community Medicine, University of California San Francisco, San Francisco, CA 94110, USA;
| | - Kaiming Tao
- Division of Infectious Diseases, Department of Medicine, Stanford University, Stanford, CA 94305, USA (J.S.); (S.-Y.R.)
| | - Vinie Kouamou
- Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare 00263, Zimbabwe;
| | - Ava Avalos
- Careena Center for Health, Gaborone, Botswana
| | - Jake Scott
- Division of Infectious Diseases, Department of Medicine, Stanford University, Stanford, CA 94305, USA (J.S.); (S.-Y.R.)
| | - Philip M. Grant
- Division of Infectious Diseases, Department of Medicine, Stanford University, Stanford, CA 94305, USA (J.S.); (S.-Y.R.)
| | - Soo-Yon Rhee
- Division of Infectious Diseases, Department of Medicine, Stanford University, Stanford, CA 94305, USA (J.S.); (S.-Y.R.)
| | | | - Michael R. Jordan
- Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, MA 02111, USA
- Collaboratory for Emerging Infectious Diseases and Response (CEIDR), Tufts University, Medford, MA 02155, USA
| | - Rebecca L. Morgan
- School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Robert W. Shafer
- Division of Infectious Diseases, Department of Medicine, Stanford University, Stanford, CA 94305, USA (J.S.); (S.-Y.R.)
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Mendoza I, Lázaro A, Espinosa A, Sánchez L, Horta AM, Torralba M. Effectiveness, durability and safety of dolutegravir and lamivudine versus bictegravir, emtricitabine and tenofovir alafenamide in a real-world cohort of HIV-infected adults. PLoS One 2023; 18:e0291480. [PMID: 37773939 PMCID: PMC10540944 DOI: 10.1371/journal.pone.0291480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 08/24/2023] [Indexed: 10/01/2023] Open
Abstract
OBJECTIVE Dolutegravir plus lamivudine (2-DR) is suggested as an initial and switch option in HIV-1 treatment. The aim of this study was to analyze the effectiveness, durability, and safety of 2-DR compared to bictegravir/emtricitabine/tenofovir alafenamide (3-DR). PATIENTS AND METHODS This was an observational, ambispective study that included all treatment-naïve (TN) and treatment-experienced (TE) people living with HIV/AIDS (PLWH), who started 2-DR or 3-DR between 01 July 2018, and 31 January 2022. The primary endpoint was non-inferiority, at 24 and 48 weeks, of 2-DR vs 3-DR regarding the percentage of PLWH with viral load (VL)<50 and 200 copies/mL in TN (12% margin) and VL≥50 and 200 copies/mL in TE (4% margin). Durability of response and safety were also measured. RESULTS 292 PLWH were included (39 TN and 253 TE). In TN PLWH, non-inferiority was not achieved at 24 weeks (17; 95% CI -17 to 51 p = 0.348). By week 48, all PLWH on 3-DR maintained VL<50 copies/mL compared to 70% of PLWH on 2-DR although without reaching statistical significance (-33; 95% CI -60 to -10 p = 0.289). Non-inferiority was not achieved in TE PLWH either at 24 (0.4; 95% CI -9 to 10 p = 1) or at 48 weeks (4.5; 95% CI -0.5 to 9 p = 0.132). In TN, the risk of treatment discontinuation was similar between groups (HR: 0.31, p = 0.07); similar rates were also found in TE (HR: 1.3, p = 0.38). TE PLWH on 2-DR showed a better safety profile compared to 3-DR (p = 0.017). CONCLUSION Our results did not show non-inferiority in terms of virological effectiveness. Additionally, durability and safety of 2-DR were confirmed to be similar to 3-DR.
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Affiliation(s)
- Inés Mendoza
- Pharmacy Department, Hospital Universitario de Guadalajara, Guadalajara, Spain
- Alcalá University, Alcalá de Henares, Spain
| | - Alicia Lázaro
- Pharmacy Department, Hospital Universitario de Guadalajara, Guadalajara, Spain
| | - Alfredo Espinosa
- Internal Medicine Department, Research Unit, Hospital Universitario de Guadalajara, Guadalajara, Spain
| | - Lorenzo Sánchez
- Internal Medicine Department, Research Unit, Hospital Universitario de Guadalajara, Guadalajara, Spain
| | - Ana María Horta
- Pharmacy Department, Hospital Universitario de Guadalajara, Guadalajara, Spain
- Alcalá University, Alcalá de Henares, Spain
| | - Miguel Torralba
- Alcalá University, Alcalá de Henares, Spain
- Internal Medicine Department, Research Unit, Hospital Universitario de Guadalajara, Guadalajara, Spain
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Martínez-Serra A, De Lazzari E, Berrocal L, Foncillas A, De La Mora L, Inciarte A, Chivite I, González-Cordón A, Martínez-Rebollar M, Torres B, Laguno M, Blanco JL, Martínez E, Mallolas J, Ambrosioni J. Clinical use and effectiveness of dolutegravir and lamivudine: a long-term, real-world, retrospective study. J Antimicrob Chemother 2023:dkad189. [PMID: 37311224 DOI: 10.1093/jac/dkad189] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/30/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND The use of dolutegravir/lamivudine is based on solid clinical trials; however, real-world data remain limited. OBJECTIVES To provide data on the clinical use and effectiveness of dolutegravir/lamivudine in persons with HIV in a real-world scenario. PATIENTS AND METHODS Retrospective, single-centre and observational study. We included all adults starting dolutegravir/lamivudine since November 2014. We reported all demographic, virological and immunological variables at baseline and assessed effectiveness [on treatment (OT), modified ITT (mITT) and ITT in those persons who reached 6 and 12 month follow-ups (M6 and M12). RESULTS Of the 1058 persons, 9 were treatment-naive; the final analysis included 1049 treatment-experienced people with HIV. Median (IQR) follow-up was 1 (0.3-1.6) years, with 81% and 63% persons reaching M6 and M12, respectively. The longest use of dolutegravir/lamivudine was 7.4 years. Per OT, mITT and ITT, HIV-RNA < 50 copies/mL was 97%, 92% and 81% (M6) and 98%, 90% and 80% (M12), respectively. Females [adjusted risk ratio, aRR (95% CI): 1.69 (1.19-2.40)]; immediate, previous PI-based regimen [aRR (95% CI): 1.67 (1.09-2.56)]; and viral load (VL) ≥ 50 copies/mL at dolutegravir/lamivudine initiation [aRR (95% CI): 3.36 (2.32-4.88)] were independently associated with lack of effectiveness at M12; other demographic, immunological and virological variables like previous M184V/I substitutions or virological failure, were unrelated. Of the total, 944 (90%) continued dolutegravir/lamivudine. The most frequent known reason for discontinuation was toxicity [48 (46%) cases]. CONCLUSIONS In our real-world experience, virological suppression rates were high for treatment-experienced persons on dolutegravir/lamivudine; however, we identified subgroups with a higher risk of lack of effectiveness at M12, who may benefit from closer follow-ups.
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Affiliation(s)
- Adrián Martínez-Serra
- Infectious Disease Department, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Elisa De Lazzari
- Infectious Disease Department, School of Medicine, University of Barcelona, Barcelona, Spain
- HIV Unit, Infectious Diseases Service, Hospital Clinic, Villarroel 170, 08036, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Leire Berrocal
- HIV Unit, Infectious Diseases Service, Hospital Clinic, Villarroel 170, 08036, Barcelona, Spain
| | - Alberto Foncillas
- Infectious Disease Department, School of Medicine, University of Barcelona, Barcelona, Spain
- HIV Unit, Infectious Diseases Service, Hospital Clinic, Villarroel 170, 08036, Barcelona, Spain
| | - Lorena De La Mora
- Infectious Disease Department, School of Medicine, University of Barcelona, Barcelona, Spain
- HIV Unit, Infectious Diseases Service, Hospital Clinic, Villarroel 170, 08036, Barcelona, Spain
| | - Alexy Inciarte
- Infectious Disease Department, School of Medicine, University of Barcelona, Barcelona, Spain
- HIV Unit, Infectious Diseases Service, Hospital Clinic, Villarroel 170, 08036, Barcelona, Spain
| | - Iván Chivite
- Infectious Disease Department, School of Medicine, University of Barcelona, Barcelona, Spain
- HIV Unit, Infectious Diseases Service, Hospital Clinic, Villarroel 170, 08036, Barcelona, Spain
| | - Ana González-Cordón
- Infectious Disease Department, School of Medicine, University of Barcelona, Barcelona, Spain
- HIV Unit, Infectious Diseases Service, Hospital Clinic, Villarroel 170, 08036, Barcelona, Spain
| | - María Martínez-Rebollar
- Infectious Disease Department, School of Medicine, University of Barcelona, Barcelona, Spain
- HIV Unit, Infectious Diseases Service, Hospital Clinic, Villarroel 170, 08036, Barcelona, Spain
| | - Berta Torres
- Infectious Disease Department, School of Medicine, University of Barcelona, Barcelona, Spain
- HIV Unit, Infectious Diseases Service, Hospital Clinic, Villarroel 170, 08036, Barcelona, Spain
| | - Montserrat Laguno
- Infectious Disease Department, School of Medicine, University of Barcelona, Barcelona, Spain
- HIV Unit, Infectious Diseases Service, Hospital Clinic, Villarroel 170, 08036, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - José Luis Blanco
- Infectious Disease Department, School of Medicine, University of Barcelona, Barcelona, Spain
- HIV Unit, Infectious Diseases Service, Hospital Clinic, Villarroel 170, 08036, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Esteban Martínez
- Infectious Disease Department, School of Medicine, University of Barcelona, Barcelona, Spain
- HIV Unit, Infectious Diseases Service, Hospital Clinic, Villarroel 170, 08036, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Josep Mallolas
- Infectious Disease Department, School of Medicine, University of Barcelona, Barcelona, Spain
- HIV Unit, Infectious Diseases Service, Hospital Clinic, Villarroel 170, 08036, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Juan Ambrosioni
- Infectious Disease Department, School of Medicine, University of Barcelona, Barcelona, Spain
- HIV Unit, Infectious Diseases Service, Hospital Clinic, Villarroel 170, 08036, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
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Sayan M, Sultanoglu N, Sanlidag T. Dynamics of Rilpivirine Resistance-Associated Mutation: E138 in Reverse Transcriptase among Antiretroviral-Naive HIV-1-Infected Individuals in Turkey. AIDS Res Hum Retroviruses 2023; 39:84-90. [PMID: 36301912 DOI: 10.1089/aid.2022.0065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Rilpivirine, one of the non-nucleoside reverse transcriptase inhibitors class anti-HIV agents, is used as an alternative drug to treat HIV-1-positive individuals according to current antiretroviral therapy (ART) guidelines. Mutation in the position E138 in HIV-1 reverse transcriptase (RT) leads to resistance to rilpivirine, alone reducing its susceptibility two to threefolds. The main aim of this study was to determine the dynamics of E138 mutation in the RT domain of the HIV-1 pol gene; in 6398 newly diagnosed and treatment-naive individuals in Turkey from 2013 to 2021. Rilpivirine-associated mutations were found among 424 (6.6%) out of 6398. Individuals with the E138 mutation had significantly higher HIV-1 RNA load than individuals without the E138 mutation (p = .044). The E138 mutation was mainly observed in the B subtype (40%) of HIV-1 compared to the non-B subtypes (26.9%) and the circulating recombinant forms (33.1%) (p < .001). Most E138 mutations were E138A (80%), followed by E138G (16.5%). This study uncovered the dynamics of rilpivirine-associated mutations over a long period and a large patient population. Before administering ART regimens consisting of rilpivirine, resistance monitoring is highly recommended for effective patient management in the treatment-of naive HIV-1-infected individuals.
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Affiliation(s)
- Murat Sayan
- Clinical Laboratory, PCR Unit, Kocaeli University, Kocaeli, Turkey.,DESAM Research Institute, Near East University, Nicosia, North Cyprus.,Operational Research Center in Healthcare, Near East University, Nicosia, North Cyprus
| | - Nazife Sultanoglu
- DESAM Research Institute, Near East University, Nicosia, North Cyprus.,Department of Microbiology and Clinical Microbiology, Faculty of Medicine, Near East University, Nicosia, North Cyprus
| | - Tamer Sanlidag
- DESAM Research Institute, Near East University, Nicosia, North Cyprus
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