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Rilpivirine use in the Swiss HIV cohort study: a prospective cohort study.
- Source :
-
BMC Infectious Diseases . 7/6/2017, Vol. 17, p1-10. 10p. 1 Diagram, 5 Charts. - Publication Year :
- 2017
-
Abstract
- <bold>Background: </bold>Rilpivirine is safe and effective in HIV-naïve patients with low baseline HIV-RNA or in switch strategy. It offers the advantages of few drug-drug interactions and a favourable toxicity profile. We aimed to determine the reasons for prescribing the rilpivirine (RPV)/tenofovir disoproxil (TDF)/emtricitabine (FTC) co-formulation within the Swiss HIV Cohort Study and to assess its effectiveness and safety over a 24 months period.<bold>Methods: </bold>All individuals enrolled in the Swiss HIV Cohort Study who initiated a RPV/TDF/FTC co-formulation between April 2013 and March 2014 were included. Primary outcomes were the HIV-RNA viral load (copies/mL) and CD4 cell count (cells/mm3) at 6, 12 and 24 months. Reasons for a switch to RPV/TDF/FTC were evaluated through a standardized questionnaire. We also assessed discontinuation and reasons for discontinuation of RPV/TDF/FTC until October 30, 2015.<bold>Results: </bold>Of 644 individuals who started the RPV/TDF/FTC co-formulation, only 7.5% were treatment-naïve. At 24 months, viral suppression (HIV-RNA <50 copies/mL) was achieved in 100% and 96.7% of cART-naïve and cART-experienced patients respectively. The switch to RPV was mainly done for simplification (44.6%) and to overcome central nervous system toxicity symptoms due to efavirenz (24%). Six months after switch, 74.8% of patients reported an improvement of psycho-neurological symptoms with continued improvement at 12 months for almost 80%. However, one quarter of patients reported a discontinuation of RPV/TDF/FTC on October 30, 2015 after a median time of 18.4 months. Reasons for discontinuation included physician decision (5.3%) and side-effects (3.9%) mainly related to the central nervous system and to renal toxicity.<bold>Conclusion: </bold>The RPV/TDF/FTC co-formulation was safe and effective throughout 24 months of follow-up but barely prescribed for HIV-naïve patients. Despite excellent virological suppression among both treatment-naïve and -experienced patients, we observed a high rate of treatment discontinuation. [ABSTRACT FROM AUTHOR]
- Subjects :
- *RILPIVIRINE
*HIV-positive persons
*DRUG interactions
*EMTRICITABINE
*TENOFOVIR
*COHORT analysis
*THERAPEUTICS
*ANTI-HIV agents
*COMBINATION drug therapy
*CLINICAL trials
*COMPARATIVE studies
*HETEROCYCLIC compounds
*HIV
*HIV infections
*LONGITUDINAL method
*RESEARCH methodology
*MEDICAL cooperation
*RESEARCH
*VIRAL load
*EVALUATION research
*HIGHLY active antiretroviral therapy
*TREATMENT effectiveness
*CD4 lymphocyte count
Subjects
Details
- Language :
- English
- ISSN :
- 14712334
- Volume :
- 17
- Database :
- Academic Search Index
- Journal :
- BMC Infectious Diseases
- Publication Type :
- Academic Journal
- Accession number :
- 123959994
- Full Text :
- https://doi.org/10.1186/s12879-017-2579-2