1263. Dolutegravir/Rilpivirine Switch Study in Persons with HIV and Chronic Kidney Disease: 24-week Assessment of Viral Suppression, Adherence, Treatment Satisfaction and Quality of Life

Abstract

Abstract Background Single tablet regimens (STRs) improve convenience of administering antiretroviral therapy. However, for people with HIV and chronic kidney disease (CKD), STR options have been limited due to pharmacokinetic considerations. We evaluate the impact on viral suppression, adherence, treatment satisfaction and quality of life (QOL) of switching to dolutegravir/rilpivirine (DTG/RPV) for a cohort with HIV-1 and CKD. Methods In this 48-week single arm open label switch study, adults with HIV and a GFR< 60 mL/min/1.73m2, an HIV RNA < 50 copies/mL, and no known prior resistance to DTG or RPV were switched to DTG/RPV STR. HIV RNA and CD4 cell count were monitored quarterly. Standardized adherence, treatment satisfaction and QOL tools were administered at baseline, 24 weeks and 48 weeks. We present 24 week data. Results Between August 2019 and December 2021, 35 participants were enrolled. One participant terminated at 19 weeks when his transplant team stopped DTG/RPV due to concerns about potential drug-drug interactions following a kidney transplant. 94% of participants were Black, 57% were female, 94% were > 50 years and 43% were 65 years or older. At baseline, 23% had GFR < 30mL/min/1.73m2 and 55% had a GFR between 30 and 50mL/min/1.73m2. Of the 30 participants who have completed 24 weeks, 97% had an HIV RNA < 50 copies/mL, 67% reported an improvement in medication adherence, 70% noted an improvement in QOL and 77% in treatment satisfaction. There were no serious adverse events. Conclusion For this diverse aging cohort with HIV and CKD, DTG/RPV was efficacious, well-tolerated, and associated with improvements in adherence, treatment satisfaction and QOL. Disclosures Helena Kwakwa, MD, MPH, ViiV Healthcare: Grant/Research Support.