Publication:
Clinical experience with integrase inhibitors in HIV-2-infected individuals in Spain.

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2019

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Requena, S
Lozano, A B
Caballero, E
García, F
Nieto, M C
Téllez, R
Fernández, J M
Trigo, M
Rodríguez-Avial, I
Martín-Carbonero, L

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HIV-2 is a neglected virus despite estimates of 1-2 million people being infected worldwide. The virus is naturally resistant to some antiretrovirals used to treat HIV-1 and therapeutic options are limited for patients with HIV-2. In this retrospective observational study, we analysed all HIV-2-infected individuals treated with integrase strand transfer inhibitors (INSTIs) recorded in the Spanish HIV-2 cohort. Demographics, treatment modalities, laboratory values, quantitative HIV-2 RNA and CD4 counts as well as drug resistance were analysed. From a total of 354 HIV-2-infected patients recruited by the Spanish HIV-2 cohort as of December 2017, INSTIs had been given to 44, in 18 as first-line therapy and in 26 after failing other antiretroviral regimens. After a median follow-up of 13 months of INSTI-based therapy, undetectable viraemia for HIV-2 was achieved in 89% of treatment-naive and in 65.4% of treatment-experienced patients. In parallel, CD4 gains were 82 and 126 cells/mm3, respectively. Treatment failure occurred in 15 patients, 2 being treatment-naive and 13 treatment-experienced. INSTI resistance changes were recognized in 12 patients: N155H (5), Q148H/R (3), Y143C/G (3) and R263K (1). Combinations based on INSTIs are effective and safe treatment options for HIV-2-infected individuals. However, resistance mutations to INSTIs are selected frequently in failing patients, reducing the already limited treatment options.

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Adolescent
Adult
CD4 Lymphocyte Count
Drug Resistance, Viral
Female
HIV Infections
HIV Integrase Inhibitors
HIV-2
Humans
Male
Microbial Sensitivity Tests
Middle Aged
Mutation
RNA, Viral
Retrospective Studies
Spain
Treatment Failure

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