RT Journal Article
T1 Effectiveness of integrase strand transfer inhibitors in HIV-infected treatment-experienced individuals across Europe.
A1 Rossetti, Barbara
A1 Fabbiani, Massimiliano
A1 Di Carlo, Domenico
A1 Incardona, Francesca
A1 Abecasis, Ana
A1 Gomes, Perpetua
A1 Geretti, Anna Maria
A1 Seguin-Devaux, Carole
A1 Garcia, Federico
A1 Kaiser, Rolf
A1 Modica, Sara
A1 Shallvari, Adrian
A1 Sönnerborg, Anders
A1 Zazzi, Maurizio
K1 HIV
K1 INSTI
K1 dolutegravir
K1 effectiveness
K1 elvitegravir
K1 integrase strand transfer inhibitors
K1 raltegravir
K1 treatment-experienced
AB To explore the effectiveness and durability of integrase strand transfer inhibitor (INSTI)-based regimens in pre-treated subjects. Treatment-experienced individuals starting an INSTI-based regimen during 2012-2019 were selected from the INTEGRATE collaborative study. The time to virological failure [VF: one measurement of viral load (VL) ≥ 1000 copies/mL or two ≥ 50 copies/ml or one VL measurement ≥ 50 copies/mL followed by treatment change] and to INSTI discontinuation were evaluated. Of 13 560 treatments analysed, 4284 were from INSTI-naïve, non-viraemic (IN-NV) individuals, 1465 were from INSTI-naïve, viraemic (IN-V) individuals, 6016 were from INSTI-experienced, non-viraemic (IE-NV) individuals and 1795 were from INSTI-experienced, viraemic (IE-V) individuals. Major INSTI drug resistance mutations (DRMs) were previously detected in 4/519 (0.8%) IN-NV, 3/394 (0.8%) IN-V, 7/1510 (0.5%) IE-NV and 25/935 (2.7%) IE-V individuals. The 1-year estimated probabilities of VF were 3.1% [95% confidence interval (CI): 2.5-3.8] in IN-NV, 18.4% (95% CI: 15.8-21.2) in IN-V, 4.2% (95% CI: 3.6-4.9) in IE-NV and 23.9% (95% CI: 20.9-26.9) in IE-V subjects. The 1-year estimated probabilities of INSTI discontinuation were 12.1% (95% CI: 11.1-13.0) in IN-NV, 19.6% (95% CI: 17.5-21.6) in IN-V, 10.8% (95% CI: 10.0-11.6) in IE-NV and 21.7% (95% CI: 19.7-23.5) in IE-V subjects. Both VF and INSTI discontinuation occur at substantial rates in viraemic subjects. Detection of DRMs in a proportion of INSTI-experienced individuals makes INSTI resistance testing mandatory after failure.
PB Wiley-Blackwell Publishing Ltd.
YR 2022
FD 2022-01-18
LK http://hdl.handle.net/10668/19961
UL http://hdl.handle.net/10668/19961
LA en
NO Rossetti B, Fabbiani M, Di Carlo D, Incardona F, Abecasis A, Gomes P, et al. Effectiveness of integrase strand transfer inhibitors in HIV-infected treatment-experienced individuals across Europe. HIV Med. 2022 Aug;23(7):774-789.
DS RISalud
RD Apr 8, 2025