Results of 144-week use of the combined drug rilpivirine/tenofovir/emtricitabine in HIV-infected patients in Saint Petersburg


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Resumo

Objective. To evaluate the efficacy, safety, and tolerance of the combined drug RPV/TDF/FTC (Еviplera) in HIV-infected patients who have received treatment for 144 weeks.Materials and methods. Medical records of 213 HIV-infected outpatients who had received RPV/TDF/FTC for 3 years were retrospectively analyzed. The main criterion for the effectiveness of the regimen was the proportion of patients having an undetectable viral load at week 144 of treatment. The additional criteria for evaluating the effectiveness and safety of the regimen were the time course of changes in the count of CD4+-lymphocytes and the frequency and nature of adverse events (AEs).Results. At week 144 of treatment, 91% of patients continued their RPV/TDF/FTC regimen. 98.4% of them had a viral load of < 50 copies/ml and 99.5% had that of <500 copies/ml in both the patients who had received ART for the first time and those who had experienced treatment. Only 5.8% of patients discontinued the drug due to AEs. In 2 (0.9%) patients, the regimen was replaced because of the development of HIV drug resistance. The mean CD4+-lymphocyte counts increased by 74 cells/μl at week 144 of treatment. Conclusion. The RPV/TDF/FTC regimen demonstrated its effectiveness and safety. AEs occurred in 20% of patients older than 50 years and in only 1.3% of those younger than 50 years old (p < 0.05). Before prescribing RPV/TDF/FTC to patients older than 50 years, it is necessary to thoroughly estimate glomerular filtration rate and to perform densitometry. It is advisable to prescribe RPV/TDF/FTC as a first-line regimen both to retain the patient on the therapy and to prevent dyslipidemia and a cardiovascular risk.

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Sobre autores

Natalia Sizova

Saint Petersburg Center for Prevention and Control of AIDS and Communicable Diseases

Email: natalia_v_sizova@mail.ru

Svetlana Maiorova

Saint Petersburg Center for Prevention and Control of AIDS and Communicable Diseases

Email: svetlana.majorova11@jandex.ru

Vasilisa Bratkova

Saint Petersburg Center for Prevention and Control of AIDS and Communicable Diseases

Email: vasiliska_3@mail.ru

Aleksandra Sotnkova

Saint Petersburg Center for Prevention and Control of AIDS and Communicable Diseases

Email: sasha.yakubenko@gmail.com

Atiana Malkova

Saint Petersburg Center for Prevention and Control of AIDS and Communicable Diseases

Email: jenavi76@mail.ru

Denis Gusev

Saint Petersburg Center for Prevention and Control of AIDS and Communicable Diseases

Email: gusevden-70@mail.ru

Bibliografia

  1. Ocampo A., Domingo P., Fernández P., Diz J., Barberá J.R., Sepúlveda M.A. Lipid changes and tolerability in a cohort of adult HIV-infected patients who switched to rilpivirine/emtricitabine/tenofovir due to intolerance to previous combination ART: the PRO-STR study. J. Antimicrob. Chemother. 201; 73: 2171-6. doi: 10.1093/jac/dky175
  2. Taramasso L., Tatarelli P., Ricci E., Madeddu G., Menzaghi B. Improvement of lipid profile after switching from efavirenz or ritonavir-boosted protease inhibitors to rilpivirine or oncedaily integrase inhibitors: results from a large observational cohort study (SCOLTA). BMC Infect. Dis. 2018; 18: 357. doi: 10.1186/s12879-018-3268-5

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