Efficacy and safety of abacavir/lamivudine plus rilpivirine as a first-line regimen in treatment-naive HIV-1 infected adults.

ABSTRACT: BACKGROUND:The anti-retroviral combination of abacavir/lamivudine plus rilpivirine (ABC/3TC/RPV) is not recommended by international guidelines as the first-line regimen. However, it is potent, well-tolerated, and affordable, especially in resource-limited settings. This study evaluates the efficacy and safety of ABC/3TC/RPV as an initial regimen for treatment-naïve HIV-1 infected patients. METHODS:A retrospective study was conducted in the largest HIV care centre in Singapore, with data collected June 2011 to September 2017. All treatment-naïve HIV-1 infected adults prescribed ABC/3TC as part of their initial anti-retroviral therapy regimen were included. The third drug was a non-nucleoside reverse-transcriptase inhibitor (NNRTI) such as RPV or efavirenz (EFV), or boosted protease-inhibitor (PI). Patients were followed up for 48 weeks. The primary end-point was the percentage of patients achieving virologic suppression, analysed using on-treatment analysis. Secondary outcomes included CD4-count change, treatment discontinuation and treatment-related adverse events. RESULTS:170 patients were included in the study, 66 patients in the RPV group, 104 patients in the comparator group (EFV or boosted PI). 96% (n?=?24) in the RPV group and 87% (n?=?26) in the comparator group achieved viral suppression at 48 weeks (p?=?0.28). Median (interquartile range) time to viral suppression was similar: 17 (14-24) weeks in the RPV group, and 21 (13-26) weeks in the comparator group. There were no statistically significant differences in the CD4 count between the two groups. 14% (n?=?9) of patients on RPV discontinued treatment before 48 weeks, compared to 30% (n?=?31) from the comparator group (p?=?0.053). Of these, 23 discontinuations were due to drug adverse effects, and only 1 attributed to RPV (p?

SUBMITTER: Ho S 

PROVIDER: S-EPMC7243331 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature