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Multicenter Study
. 2020 Jul 20;17(1):45.
doi: 10.1186/s12981-020-00302-2.

Effectiveness of the combination elvitegravir/cobicistat/tenofovir/emtricitabine (EVG/COB/TFV/FTC) plus darunavir among treatment-experienced patients in clinical practice: a multicentre cohort study

Inés Suárez-García  1   2   3 , Cristina Moreno  4 , Marta Ruiz-Algueró  4 , María Jesús Pérez-Elías  5 , Marta Navarro  6 , Marcos Díez Martínez  7 , Pompeyo Viciana  8 , Laura Pérez-Martínez  9 , Miguel Górgolas  10 , Concha Amador  11 , Miguel Alberto de Zárraga  12 , Inma Jarrín  4 ; Cohort of the Spanish HIV/AIDS Research Network (CoRIS)
Collaborators, Affiliations
Multicenter Study

Effectiveness of the combination elvitegravir/cobicistat/tenofovir/emtricitabine (EVG/COB/TFV/FTC) plus darunavir among treatment-experienced patients in clinical practice: a multicentre cohort study

Inés Suárez-García et al. AIDS Res Ther. .

Abstract

Background: The aim of this study was to investigate the effectiveness and tolerability of the combination elvitegravir/cobicistat/tenofovir/emtricitabine plus darunavir (EVG/COB/TFV/FTC + DRV) in treatment-experienced patients from the cohort of the Spanish HIV/AIDS Research Network (CoRIS).

Methods: Treatment-experienced patients starting treatment with EVG/COB/TFV/FTC + DRV during the years 2014-2018 and with more than 24 weeks of follow-up were included. TFV could be administered either as tenofovir disoproxil fumarate or tenofovir alafenamide. We evaluated virological response, defined as viral load (VL) < 50 copies/ml and < 200 copies/ml at 24 and 48 weeks after starting this regimen, stratified by baseline VL (< 50 or ≥ 50 copies/ml at the start of the regimen).

Results: We included 39 patients (12.8% women). At baseline, 10 (25.6%) patients had VL < 50 copies/ml and 29 (74.4%) had ≥ 50 copies/ml. Among patients with baseline VL < 50 copies/ml, 85.7% and 80.0% had VL < 50 copies/ml at 24 and 48 weeks, respectively, and 100% had VL < 200 copies/ml at 24 and 48 weeks. Among patients with baseline VL ≥ 50 copies/ml, 42.3% and 40.9% had VL < 50 copies/ml and 69.2% and 68.2% had VL < 200 copies/ml at 24 and 48 weeks. During the first 48 weeks, no patients changed their treatment due to toxicity, and 4 patients (all with baseline VL ≥ 50 copies/ml) changed due to virological failure.

Conclusions: EVG/COB/TFV/FTC + DRV was well tolerated and effective in treatment-experienced patients with undetectable viral load as a simplification strategy, allowing once-daily, two-pill regimen with three antiretroviral drug classes. Effectiveness was low in patients with detectable viral loads.

Keywords: Cohort studies; Darunavir; HIV infection; Highly active antiretroviral therapy.

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Conflict of interest statement

ISG has received conference grants or speaker fees from BMS, ViiV Healthcare and Gilead. IJ has received teaching fees from ViiV Healthcare. All other authors declare that they have no conflict of interest related to this work.

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