ATV/r‐based regimens: durable virological suppression and good tolerability as switch strategy from NNRTI‐containing regimens in a real‐life cohort

Abstract

Current therapeutic options for the treatment of HIV provide high rates of virological suppression and good tolerability. However, as long‐term treatment success has become a realistic goal, data evaluating the long‐term efficacy and safety of switching strategies become more needed. The purpose of this sub‐analysis is to describe the long‐term outcomes of ATV/r regimens after switching from combinations containing non‐nucleoside reverse transcriptase inhibitor (NNRTI) in a clinical setting. Non‐comparative, retrospective study including data from 3 European databases (France – DatAids, Germany‐KompNet, Sweden‐InfCare). Data from antiretroviral (ARV)‐experienced adults starting an ATV/r‐regimen between October 2004‐March 2007 were extracted every 6‐months (maximum follow‐up 5 years). Time to virological failure (VF) was analysed by the Kaplan‐Meier method. Reasons for discontinuation and safety data were also collected. Of 1294 patients analysed, 250 switched from a NNRTI‐based regimen. Patients were predominantly male (74%); median age 42 years (min, max: 23, 85); prior ARV exposure: median 5.0 years. At baseline (BL), 56% of patients had HIV‐1 RNA<500 c/mL and 31% had<50 c/mL; median (min, max) CD4 cell count: 388 (6, 1299) cells/mm3. After 3‐year follow‐up, the probability of not having VF was 79% (95% CI 65–88%) and 62% (95% CI 52%–70%) for patients with BL HIV‐1 RNA<or≥50 c/mL, respectively. The most frequent reasons for discontinuation were “unknown” (18%) and adverse events (8%). Hyperbilirubinemia was reported as reason for discontinuation in only 2 patients. In a clinical setting, switching from NNRTI to ATV/r‐based regimen is associated with sustained virological suppression and good tolerability.Time to virological failure (2 consecutive HIV‐1 RNA≥50 c/mL or 1 HIIV‐1 RNA≥50 c/mL followed by discontinuation).image