HIV: rilpivirine + booster darunavir effective in patients with extended ART exposure

  • Pasquau J & al.
  • BMC Infect Dis
  • 28 Feb 2019

  • curated by Liz Scherer
  • Clinical Essentials
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Takeaway

  • Preliminary findings confirm that dual therapy rilpivirine (RPV; Edurant) plus booster darunavir (DRVb) is an effective treatment strategy for patients with advanced HIV and extended antiretroviral therapy (ART) exposure.

Why this matters

  • Consider RPV+DRVb as an alternative to triple therapy in both stable, virologically suppressed and patients with low CD4 nadir, viral failure (VF), and previous nonsuppressive ART.

Key results

  • 161 patients, median time since HIV diagnosis 17 (interquartile range [IQR], 10-23) years, median ART receipt 14 (IQR, 6-18) years.
  • 25.5% (41) had unsuppressed viremia (50-1000 copies/mL), 36.6% (59) had previous VF at baseline.
  • At week 24, 87.6% (141/161) of intent-to-treat (ITT) on RPV+DRVb showed no VF; 17 discontinued.
  • 94.6% (141/149) comprised on-treatment (OT) population completed study with no VF criteria signs.
  • At week 24, 82.6% (133/161), 89.3% (133/149) of ITT, OT patients, respectively, had VF
  • Previous failure with darunavir did not increase likelihood for VF with dual therapy: 13.3% (4/30) vs 5.5% (1/18); P=.348.
  • No serious adverse events observed.

Study design

  • Retrospective observational, multicenter cohort analyzing RPV+DRVb effectiveness in advanced HIV infections.
  • Funding: Janssen-Cilag Spain.

Limitations

  • Retrospective.
  • Inclusion bias.
  • Short follow-up.