Impact of NRTI resistance mutations on virological effectiveness of antiretroviral regimens containing elvitegravir: a multi-cohort study

Sara Modica, David Redi, Roberta Gagliardini, Emanuela Giombini, Antonia Bezenchek, Domenico Di Carlo, Franco Maggiolo, Francesca Lombardi, Alberto Borghetti, Damiano Farinacci, Annapaola Callegaro, Maria R. Gismondo, Manuela Colafigli, Gaetana Sterrantino, Andrea Costantini, Sergio M. Ferrara, Stefano Rusconi, Maurizio Zazzi, Barbara Rossetti, Andrea De LucaNicola Gianotti

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Antiretroviral drug resistance mutations remain a major cause of treatment failure. OBJECTIVES: To evaluate the impact of NRTI resistance mutations on virological effectiveness of elvitegravir-containing regimens. MATERIALS AND METHODS: We selected treatment-experienced HIV-1-infected patients starting elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/F/TAF) or elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate (E/C/F/TDF), with at least one protease/reverse transcriptase genotype available before switching and at least one HIV-1 RNA viral load (VL) measurement during follow-up. The primary endpoint was virological failure (VF), defined as one VL value of ≥1000 copies/mL or two consecutive VL values of >50 copies/mL. RESULTS: We included 264 ART regimens: 75.6% male, median (IQR) age 47 years (39-53), 7 years (3-16) of HIV infection, nadir CD4+ 247 cells/mm3 (105-361), 81.5% with VL ≤50 copies/mL and 11.7% with at least one NRTI mutation at baseline. Eleven (5.2%) VFs occurred in virologically suppressed patients versus eight (15.1%) in viraemic patients. The estimated probability of VF at 48 weeks with versus without any NRTI mutation was 7.4% (95% CI 2.3-12.5) versus 3.8% (2.1-5.5) in virologically suppressed patients and 66.7% (39.5-93.9) versus 11.2% (6.5-15.9) (P
Original languageEnglish
Pages (from-to)1-6
Number of pages6
JournalJournal of Antimicrobial Chemotherapy
Volume75
Issue number1
DOIs
Publication statusPublished - 2020

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