Long-term virological suppression on first-line efavirenz+tenofovir+emtricitabine/lamivudine for HIV-1

long-term virological suppression working group for the collaboration of observational HIV epidemiological research Europe (COHERE) in EuroCord

Research output: Contribution to journalArticle

Abstract

Evaluate long-term rates of virological failure and treatment interruption for people living with HIV (PLWHIV) with viral suppression on first-line efavirenz+tenofovir disoproxil fumarate+emtricitabine/lamivudine (EFV+TDF+FTC/3TC), and compare these according to patient characteristics.Methods:PLWHIV enrolled in the Collaboration of Observational HIV Epidemiological Research Europe cohort collaboration, who started first-line EFV+TDF+FTC/3TC at age at least 16 years and had viral suppression (<200 copies/ml) within 9 months were included. Rates of virological failure (≥200 copies/ml) and (complete) treatment interruption were estimated according to years since initial suppression. We used Poisson regression to examine associations of baseline characteristics with rates of virological failure or treatment interruption.Results:Among 19527 eligible PLWHIV with median (interquartile range) follow-up 3.7 (2.0-5.6) years after initial viral suppression, the estimated rate of the combined incidence of virological failure or treatment interruption fell from 9.0/100 person-years in the first year to less than 4/100 person-years beyond 3 years from suppression; considering only those remaining on EFV+TDF+FTC/3TC, the combined rate dropped from 8.2/100 person-years in the first year to less than 3.5/100 person-years beyond 3 years. PLWHIV with injecting drug-related or heterosexual transmission were at higher risk of virological failure or treatment interruption, as were those of Black ethnicity. PLWHIV aged less than 35 years were at higher risk of virological failure and treatment interruption.Conclusion:PLWHIV starting first-line EFV+TDF+FTC/3TC had low rates of virological failure and treatment interruption up to 10 years from initial suppression. Demographic characteristics can be used to identify subpopulations with higher risks of these outcomes.

Original languageEnglish
Pages (from-to)745-751
Number of pages7
JournalAIDS
Volume33
Issue number4
DOIs
Publication statusPublished - Mar 15 2019
Externally publishedYes

Keywords

  • antiretroviral therapy
  • viral failure
  • viral rebound
  • viral suppression
  • virological control

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

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    long-term virological suppression working group for the collaboration of observational HIV epidemiological research Europe (COHERE) in EuroCord (2019). Long-term virological suppression on first-line efavirenz+tenofovir+emtricitabine/lamivudine for HIV-1. AIDS, 33(4), 745-751. https://doi.org/10.1097/QAD.0000000000002126