Rilpivirine use in the Swiss HIV cohort study: a prospective cohort study.

Sculier, Delphine; Gayet-Ageron, Angèle; Battegay, Manuel; Cavassini, Matthias; Fehr, Jan; Hirzel, Cédric; Schmid, Patrick; Bernasconi, Enos; Calmy, Alexandra (2017). Rilpivirine use in the Swiss HIV cohort study: a prospective cohort study. BMC infectious diseases, 17(1), p. 476. BioMed Central 10.1186/s12879-017-2579-2

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BACKGROUND

Rilpivirine is safe and effective in HIV-naïve patients with low baseline HIV-RNA or in switch strategy. It offers the advantages of few drug-drug interactions and a favourable toxicity profile. We aimed to determine the reasons for prescribing the rilpivirine (RPV)/tenofovir disoproxil (TDF)/emtricitabine (FTC) co-formulation within the Swiss HIV Cohort Study and to assess its effectiveness and safety over a 24 months period.

METHODS

All individuals enrolled in the Swiss HIV Cohort Study who initiated a RPV/TDF/FTC co-formulation between April 2013 and March 2014 were included. Primary outcomes were the HIV-RNA viral load (copies/mL) and CD4 cell count (cells/mm(3)) at 6, 12 and 24 months. Reasons for a switch to RPV/TDF/FTC were evaluated through a standardized questionnaire. We also assessed discontinuation and reasons for discontinuation of RPV/TDF/FTC until October 30, 2015.

RESULTS

Of 644 individuals who started the RPV/TDF/FTC co-formulation, only 7.5% were treatment-naïve. At 24 months, viral suppression (HIV-RNA <50 copies/mL) was achieved in 100% and 96.7% of cART-naïve and cART-experienced patients respectively. The switch to RPV was mainly done for simplification (44.6%) and to overcome central nervous system toxicity symptoms due to efavirenz (24%). Six months after switch, 74.8% of patients reported an improvement of psycho-neurological symptoms with continued improvement at 12 months for almost 80%. However, one quarter of patients reported a discontinuation of RPV/TDF/FTC on October 30, 2015 after a median time of 18.4 months. Reasons for discontinuation included physician decision (5.3%) and side-effects (3.9%) mainly related to the central nervous system and to renal toxicity.

CONCLUSION

The RPV/TDF/FTC co-formulation was safe and effective throughout 24 months of follow-up but barely prescribed for HIV-naïve patients. Despite excellent virological suppression among both treatment-naïve and -experienced patients, we observed a high rate of treatment discontinuation.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology

UniBE Contributor:

Hirzel, Cédric

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1471-2334

Publisher:

BioMed Central

Language:

English

Submitter:

Annelies Luginbühl

Date Deposited:

25 Oct 2017 16:34

Last Modified:

30 Oct 2017 11:23

Publisher DOI:

10.1186/s12879-017-2579-2

PubMed ID:

28683720

Uncontrolled Keywords:

First-line regimen HIV-1 Rilpivirine Safety Treatment simplification Virological response

BORIS DOI:

10.7892/boris.101882

URI:

https://boris.unibe.ch/id/eprint/101882

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