Journal Article

Initiation of rilpivirine, tenofovir and emtricitabine (RPV/TDF/FTC) regimen in 363 patients with virological vigilance assessment in ‘real life’

Corinne Amiel, Veronique Schneider, Sabine Guessant, Mohammed Hamidi, Khadijah Kherallah, Marie-Gisele Lebrette, Julie Chas, Catherine Lependeven and Gilles Pialoux

in Journal of Antimicrobial Chemotherapy

Volume 69, issue 12, pages 3335-3339
Published in print December 2014 | ISSN: 0305-7453
Published online August 2014 | e-ISSN: 1460-2091 | DOI: https://dx.doi.org/10.1093/jac/dku294
Initiation of rilpivirine, tenofovir and emtricitabine (RPV/TDF/FTC) regimen in 363 patients with virological vigilance assessment in ‘real life’

More Like This

Show all results sharing these subjects:

  • Medical Oncology
  • Critical Care

GO

Show Summary Details

Preview

Objectives

To study the single-tablet regimen (STR) combination rilpivirine/tenofovir/emtricitabine (RPV/TDF/FTC) as soon as it became available. We describe a 14 month follow-up in a real clinical setting with a focus on resistance to RPV/TDF/FTC and polymorphisms associated with these drugs.

Methods

We estimated drug resistance at STR baseline by combining all available resistance tests, resulting in a cumulative virtual genotype. Physicians were advised of current or archived resistance mutations for the three drugs. Virological response was analysed according to resistance genotype at baseline.

Results

Three hundred and sixty-three patients received RPV/TDF/FTC; 79% had received previous treatment and RPV/TDF/FTC was the result of a switch of one drug to rilpivirine in two-thirds of cases. The cumulative genotype showed 4% of rilpivirine resistance mutations at baseline and 16% of polymorphisms concerning non-nucleoside reverse transcriptase inhibitors (NNRTIs). With a median duration of STR of 8 months, 78% of patients with these polymorphisms were virologically suppressed compared with 96% with wild-type genotypes. Five genotypes were determined during the follow-up, revealing three rilpivirine resistance-associated mutations: E138Q/Y181I, M230L and K101P (potentially with a K101Q intermediate).

Conclusions

This observational study reflects routine clinical practice and the relevance of virological advice. It also confirms the efficacy of this STR (RPV/TDF/FTC) for naive and virologically suppressed pretreated patients with a low prevalence of virological failure and resistance if the cumulative baseline genotype is free of resistance to NNRTIs and/or polymorphisms associated with NNRTIs.

Keywords: HIV-1; STR; cumulative genotype; resistance; vigilance

Journal Article.  2529 words. 

Subjects: Medical Oncology ; Critical Care

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content.