Switching to coformulated bictegravir, emtricitabine, and tenofovir alafenamide maintained viral suppression in adults with historical virological failures and K65N/R mutation

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Title:	Switching to coformulated bictegravir, emtricitabine, and tenofovir alafenamide maintained viral suppression in adults with historical virological failures and K65N/R mutation
Authors:	Tsai, Mao -Song Sun, Hsin-Yun Chen, Cheng-Pin Lee, Chen -Hsiang Lee, Chun -Yuan Liu, Chun -Eng Tang, Hung -Jen Hung, Tung-Che Li, Chia -Wen Lee, Yuan -Ti Liou, Bo -Huang Yang, Chia-Jui Hung, Chien-Ching
Contributors:	Far Eastern Memorial Hospital Fu Jen Catholic University National Taiwan University National Taiwan University Hospital National Taiwan University Chang Gung Memorial Hospital Chang Gung University Kaohsiung Medical University Kaohsiung Municipal Siao-Gang Hospital Kaohsiung Medical University Kaohsiung Medical University Changhua Christian Hospital Chi Mei Hospital Chia Nan University of Pharmacy & Science, Department of Health and Nutrition National Cheng Kung University National Cheng Kung University Hospital Chung Shan Medical University Chung Shan Medical University Chung Shan Medical University Hospital Mackay Memorial Hospital National Yang Ming Chiao Tung University National Taiwan University National Taiwan University National Taiwan University Hospital China Medical University Taiwan China Medical University Hospital - Taiwan China Medical University Taiwan
Keywords:	hiv-1 reverse-transcriptase thymidine-analog mutations disoproxil fumarate drug-resistance k65r mutation infection dolutegravir prevalence recommendations multicenter
Date:	2023
Issue Date:	2023-12-11 13:59:52 (UTC+8)
Publisher:	ELSEVIER SCI LTD
Abstract:	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/ )
Relation:	INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES, v.126, n.CB2, pp.CC2, pp.-,
Appears in Collections:	[Dept. of Health and Nutrition (including master's program)] Periodical Articles

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