%0 Journal Article
%A Rossetti, Barbara
%A Fabbiani, Massimiliano
%A Di Carlo, Domenico
%A Incardona, Francesca
%A Abecasis, Ana
%A Gomes, Perpetua
%A Geretti, Anna Maria
%A Seguin-Devaux, Carole
%A Garcia, Federico
%A Kaiser, Rolf
%A Modica, Sara
%A Shallvari, Adrian
%A Sönnerborg, Anders
%A Zazzi, Maurizio
%A EuResist Network, INTEGRATE study group
%T Effectiveness of integrase strand transfer inhibitor-based regimens in HIV-infected treatment-naive individuals: results from a European multi-cohort study.
%D 2021
%U http://hdl.handle.net/10668/18143
%X INSTIs have become a pillar of first-line ART. Real-world data are needed to assess their effectiveness in routine care. We analysed ART-naive patients who started INSTI-based regimens in 2012-19 whose data were collected by INTEGRATE, a European collaborative study including seven national cohorts. Kaplan-Meier analyses assessed time to virological failure (VF), defined as one viral load (VL) ≥1000 copies/mL, two consecutive VLs ≥50 copies/mL, or one VL ≥50 copies/mL followed by treatment change after ≥24 weeks of follow-up, and time to INSTIs discontinuation (INSTI-DC) for any reason. Factors associated with VF and INSTI-DC were explored by logistic regression analysis. Of 2976 regimens started, 1901 (63.9%) contained dolutegravir, 631 (21.2%) elvitegravir and 444 (14.9%) raltegravir. The 1 year estimated probabilities of VF and INSTI-DC were 5.6% (95% CI 4.5-6.7) and 16.2% (95% CI 14.9-17.6), respectively, and were higher for raltegravir versus both elvitegravir and dolutegravir. A baseline VL ≥100 000 copies/mL [adjusted HR (aHR) 2.17, 95% CI 1.55-3.04, P 3 drugs versus 3 drugs (aHR 2.73, 95% CI 1.55-4.79, P  This large multi-cohort study indicates high effectiveness of elvitegravir- or dolutegravir-based first-line ART in routine practice across Europe.
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