Author, as appears in the article.: Teira, Ramon; Diaz-Cuervo, Helena; Aragao, Filipa; Marguet, Sophie; de la Fuente, Belen; Jose Munoz, Maria; Abdulghani, Nadia; Ribera, Esteban; Domingo, Pere; Deig, Elisabeth; Peraire, Joaquim; Roca, Bernardino; Montero, Marta; Jose Galindo, Maria; Romero, Alberto; Espinosa, Nuria; Lozano, Fernando; Dolores Merino, Maria; Martinez, Elisa; Geijo, Paloma; Estrada, Vicente; Garcia, Josefina; Antonia Sepulveda, M.; Berenguer, Juan;

Department: Medicina i Cirurgia

URV's Author/s: Peraire Forner, José Joaquin

Keywords: Suppression Phase-3 Infected patients Dolutegravir Antiretroviral therapy

Abstract: BackgroundSince 1996, the standard of care (SOC) therapy for HIV treatment has consisted of a backbone of two nucleoside analogue reverse transcriptase inhibitors (NRTI) paired with a third agent. Use of two-drug combinations (2DC) has been considered for selected patients to avoid toxicities associated with the use of NRTIs. This study aimed to compare the real-world outcomes of integrase strand transfer inhibitor (INSTI)-containing triple therapy (TT) to dolutegravir- (DTG) and/or boosted protease inhibitor (bPI)-based 2DC in a large Spanish cohort of HIV patients.MethodsA retrospective analysis was performed using data from the VACH cohort, a prospective multicentre Spanish cohort of adult HIV patients. All treatment experienced patients initiating a TT of an INSTI combined with two NRTIs or a 2DC-containing DTG and/or a bPI between 01/01/2012 and 01/06/2017 were included. The unit of analysis was patient-regimens. The overall sample analysis was complemented with two sub-analyses. The first sub-analysis focused on patients treated with a backbone plus DTG compared to those treated with DTG+ one other antiretroviral. The second sub-analysis focused on patients with HIV RNA<50 copies/mL at baseline, irrespective of the regimen used. The following endpoints were assessed: time to discontinuation for any reason, time to switch due to virologic failure, and time to switch due to toxicity (reasons for discontinuation according to clinician report in the database). Time-to-event analyses were conducted using Kaplan-Meier survival curves and Cox regression models.ResultsOverall 7,481 patients were included in the analysis, contributing to 9,243 patient-regimens. Patient characteristics at baseline differed among groups, with the 2DC group being significantly older and having a higher proportion of women, a longer time on ART and a higher number of previous virologic failures. Median (95% Confidence Interval [C.I.]) time to switch was 2.5 years (2.3, 2.7) in 2DC group versus 2.9 years (2.7, 3.0) in TT. Adjusted hazard ratios (95% C.I.) for discontinuation due to any reason, virologic failure and toxicity in the 2DC vs TT group were 1.29 (1.15; 1.44), 2.06 (1.54; 2.77) and 1.18 (0.94; 1.48), respectively. Results were consistent in the two sub-analyses.ConclusionIn this analysis, time to discontinuation and probability of remaining free of virologic failure were significantly higher in patients on INSTI-based TT compared to DTG- and/or bPI-containing 2DC, with no differences in toxicity.

Thematic Areas: Zootecnia / recursos pesqueiros Sociology Sociología Serviço social Saúde coletiva Química Psychology Psicología Planejamento urbano e regional / demografia Odontología Nutrição Multidisciplinary sciences Multidisciplinary Medicine (miscellaneous) Medicina veterinaria Medicina iii Medicina ii Medicina i Materiais Matemática / probabilidade e estatística Linguística e literatura Letras / linguística Interdisciplinary research in the social sciences Interdisciplinar Human geography and urban studies History & philosophy of science Historia Geografía Geociências General medicine General biochemistry,genetics and molecular biology General agricultural and biological sciences Farmacia Environmental studies Ensino Engenharias iv Engenharias iii Engenharias ii Engenharias i Enfermagem Educação física Educação Economia Direito Demography Comunicação e informação Ciências sociais aplicadas i Ciências biológicas iii Ciências biológicas ii Ciências biológicas i Ciências ambientais Ciências agrárias i Ciência política e relações internacionais Ciência de alimentos Ciência da computação Biotecnología Biology Biodiversidade Biochemistry, genetics and molecular biology (miscellaneous) Astronomia / física Arquitetura, urbanismo e design Archaeology Antropologia / arqueologia Anthropology Agricultural and biological sciences (miscellaneous) Administração, ciências contábeis e turismo Administração pública e de empresas, ciências contábeis e turismo

licence for use: https://creativecommons.org/licenses/by/3.0/es/

Author's mail: joaquim.peraire@urv.cat

Author identifier: 0000-0001-7808-5479

Record's date: 2023-02-23

Papper version: info:eu-repo/semantics/publishedVersion

Link to the original source: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0249515

Licence document URL: http://repositori.urv.cat/ca/proteccio-de-dades/

Papper original source: Plos One. 16 (4):

APA: Teira, Ramon; Diaz-Cuervo, Helena; Aragao, Filipa; Marguet, Sophie; de la Fuente, Belen; Jose Munoz, Maria; Abdulghani, Nadia; Ribera, Esteban; Doming (2021). Real world effectiveness of standard of care triple therapy versus two-drug combinations for treatment of people living with HIV. Plos One, 16(4), -. DOI: 10.1371/journal.pone.0249515

Article's DOI: 10.1371/journal.pone.0249515

Entity: Universitat Rovira i Virgili

Journal publication year: 2021

Publication Type: Journal Publications