Could Long-Acting Cabotegravir-Rilpivirine Be the Future for All People Living with HIV? Response Based on Genotype Resistance Test from a Multicenter Italian Cohort.
Could Long-Acting Cabotegravir-Rilpivirine Be the Future for All People Living with HIV? Response Based on Genotype Resistance Test from a Multicenter Italian Cohort.
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DOI：
10.3390/jpm12020188
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发表时间：
2022-01-31
影响因子：
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通讯作者：
Di Biagio A
中科院分区：
文献类型：
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作者：
De Vito A;Botta A;Berruti M;Castelli V;Lai V;Cassol C;Lanari A;Stella G;Shallvari A;Bezenchek A;Di Biagio A
长效 (LA) 制剂旨在通过维持病毒学抑制来改善艾滋病毒感染者 (PWH) 的生活质量。然而，临床试验表明，患者的选择至关重要。事实上，HIV-1 耐药基因型测试和个体患者的体重指数在指导选择方面发挥着主导作用。我们的工作旨在估计适合接受卡博特韦 (CAB) + 利匹韦林 (RPV) 新 LA 疗法的患者。我们从抗病毒反应队列分析 (ARCA) 数据库中选择了过去 24 个月内至少进行过一次随访的所有感染者。我们排除了 HBsAg 阳性、非核苷逆转录酶抑制剂（K103N 除外）和整合酶抑制剂突变证据以及可检测到的 HIV-RNA（> 50 拷贝/mL）的患者。总体而言，目前 ARCA 中有 4103 名患者正在接受随访，但符合条件的患者总数为 1641 名（39.9%）。其中，1163人（70.9%）为男性，1399人为白人（85.3%），其中1291人（92%）为意大利出生。 HIV 感染的中位长度为 10.2 年 (IQR 6.3–16.3)，CD4 细胞/计数的中位最低点为 238 (106–366) 个细胞/mm3，最后可用 CD4 细胞/计数的中位为 706 (509–944) 个细胞/mm3。大多数感染者接受三种药物治疗（n = 1116，68%）。在接受两种药物治疗的 525 名患者 (30.3%) 中，325 名患者 (18.1%) 接受拉米夫定 (3TC) 和多替拉韦 (DTG) 治疗，只有 84 名患者 (5.1%) 接受 RPV 和 DTG 治疗。总之，根据我们的快照，大约 39.9% 的病毒学抑制患者可能是长效 CAB+RPV 治疗的合适候选者。因此，根据我们的研究结果，应考虑许多不同的变量，根据不同的个体特征制定抗逆转录病毒治疗。
Long-acting (LA) formulations have been designed to improve the quality of life of people with HIV (PWH) by maintaining virologic suppression. However, clinical trials have shown that patient selection is crucial. In fact, the HIV-1 resistance genotype test and the Body Mass Index of individual patients assume a predominant role in guiding the choice. Our work aimed to estimate the patients eligible for the new LA therapy with cabotegravir (CAB) + rilpivirine (RPV). We selected, from the Antiviral Response Cohort Analysis (ARCA) database, all PWH who had at least one follow-up in the last 24 months. We excluded patients with HBsAg positivity, evidence of non-nucleoside reverse transcriptase inhibitor (except K103N) and integrase inhibitor mutations, and with a detectable HIV-RNA (>50 copies/mL). Overall, 4103 patients are currently on follow-up in the ARCA, but the eligible patients totaled 1641 (39.9%). Among them, 1163 (70.9%) were males and 1399 were Caucasian (85.3%), of which 1291 (92%) were Italian born. The median length of HIV infection was 10.2 years (IQR 6.3–16.3) with a median nadir of CD4 cells/count of 238 (106–366) cells/mm3 and a median last available CD4 cells/count of 706 (509–944) cells/mm3. The majority of PWH were treated with a three-drug regimen (n = 1116, 68%). Among the 525 (30.3%) patients treated with two-drug regimens, 325 (18.1%) were treated with lamivudine (3TC) and dolutegravir (DTG) and only 84 (5.1%) with RPV and DTG. In conclusion, according to our snapshot, roughly 39.9% of virologically suppressed patients may be suitable candidates for long-acting CAB+RPV therapy. Therefore, based on our findings, many different variables should be taken into consideration to tailor the antiretroviral treatment according to different individual characteristics.
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DOI：
10.1097/qad.0000000000002825
发表时间：
2021-06-01
期刊：
AIDS (London, England)
影响因子：
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作者：
通讯作者：
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DOI：
10.1097/qad.0000000000003119
发表时间：
2022-03-01
期刊：
AIDS (London, England)
影响因子：
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作者：
El-Nahal WG;Shen NM;Keruly JC;Jones JL;Fojo AT;Lau B;Manabe YC;Moore RD;Gebo KA;Lesko CR;Chander G
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Chander G
DOI：
10.1097/qad.0000000000002883
发表时间：
2021-07-15
期刊：
AIDS (London, England)
影响因子：
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作者：
Cutrell AG;Schapiro JM;Perno CF;Kuritzkes DR;Quercia R;Patel P;Polli JW;Dorey D;Wang Y;Wu S;Van Eygen V;Crauwels H;Ford SL;Baker M;Talarico CL;Clair MS;Jeffrey J;White CT;Vanveggel S;Vandermeulen K;Margolis DA;Aboud M;Spreen WR;van Lunzen J
通讯作者：
van Lunzen J
影响因子：
2.2
作者：
Izzo I;Carriero C;Gardini G;Fumarola B;Chiari E;Castelli F;Quiros-Roldan E
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Quiros-Roldan E
影响因子：
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Castro-Granell V;Garin N;Jaén Á;Cenoz S;Galindo MJ;Fuster-RuizdeApodaca MJ
通讯作者：
Fuster-RuizdeApodaca MJ