Objectives: Real-world experience with coformulated bictegravir, emtricitabine, and tenofovir alafenamide (BIC/FTC/TAF) is sparse as a switch regimen among people living with HIV (PLWH) having achieved viral suppression after previous virologic failures with the emergence of K65N/R.Methods: In this retrospective study, PLWH aged >20 years who had previous virologic failures with emergent K65N/R were included for switching to BIC/FTC/TAF after having achieved plasma HIV RNA load (PVL) < 200 copies/ml for >3 months. PLWH were excluded if integrase inhibitor resistance-associated mutations were detected. The primary end point was losing virologic control (PVL > 50 copies/ml) at week 48 using a modified US Food and Drug Administration snapshot algorithm.Results: A total of 72 PLWH with K65N/R who switched to BIC/FTC/TAF were identified. A total of 42 (59.7%) had concurrent M184V/I, and 9 (12.5%) had >1 thymidine analog mutations. The median dura-tion of viral suppression was 4.7 years (interquartile range 2.3-5.8), and 97.2% (n = 70) had PVL < 50 copies/ml before switching. After a median observation of 98.6 weeks (interquartile range 77.9-120.3), 94.4% (n = 68) continued BIC/FTC/TAF. At week 48, the rate of losing virologic control was 2.8% (2/72). M184V/I was not associated with viral rebound.Conclusion: Despite the emergence of K65N/R + /-M184V/I after virologic failures, BIC/FTC/TAF could be an option for simplification after viral suppression.(c) 2022 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )
關聯:
INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES, v.126, n.CB2, pp.CC2, pp.-,
