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Arnalich Fernandez, FranciscoAuthorMartin Carbonero, LuzAuthorMalmierca Corral, EduardoAuthorSendagorta Cudos, Elena MariaAuthorHerranz Pinto, Pedro FranciscoAuthorGonzalez Baeza, AliciaAuthorGorgolas MAuthor

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Effectiveness of the combination elvitegravir/cobicistat/tenofovir/emtricitabine (EVG/COB/TFV/FTC) plus darunavir among treatment-experienced patients in clinical practice: a multicentre cohort study

Publicated to:AIDS Research and Therapy. 17 (1): 45-45 - 2020-07-20 17(1), DOI: 10.1186/s12981-020-00302-2

Authors: Suarez-Garcia, Ines; Moreno, Cristina; Ruiz-Alguero, Marta; Jesus Perez-Elias, Maria; Navarro, Marta; Diez Martinez, Marcos; Viciana, Pompeyo; Perez-Martinez, Laura; Gorgolas, Miguel; Amador, Concha; Alberto de Zarraga, Miguel; Jarrin, Inma

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Abstract

© 2020 The Author(s). Background: The aim of this study was to investigate the effectiveness and tolerability of the combination elvitegravir/cobicistat/tenofovir/emtricitabine plus darunavir (EVG/COB/TFV/FTC + DRV) in treatment-experienced patients from the cohort of the Spanish HIV/AIDS Research Network (CoRIS). Methods: Treatment-experienced patients starting treatment with EVG/COB/TFV/FTC + DRV during the years 2014-2018 and with more than 24 weeks of follow-up were included. TFV could be administered either as tenofovir disoproxil fumarate or tenofovir alafenamide. We evaluated virological response, defined as viral load (VL) < 50 copies/ml and < 200 copies/ml at 24 and 48 weeks after starting this regimen, stratified by baseline VL (< 50 or ≥ 50 copies/ml at the start of the regimen). Results: We included 39 patients (12.8% women). At baseline, 10 (25.6%) patients had VL < 50 copies/ml and 29 (74.4%) had ≥ 50 copies/ml. Among patients with baseline VL < 50 copies/ml, 85.7% and 80.0% had VL < 50 copies/ml at 24 and 48 weeks, respectively, and 100% had VL < 200 copies/ml at 24 and 48 weeks. Among patients with baseline VL ≥ 50 copies/ml, 42.3% and 40.9% had VL < 50 copies/ml and 69.2% and 68.2% had VL < 200 copies/ml at 24 and 48 weeks. During the first 48 weeks, no patients changed their treatment due to toxicity, and 4 patients (all with baseline VL ≥ 50 copies/ml) changed due to virological failure. Conclusions: EVG/COB/TFV/FTC + DRV was well tolerated and effective in treatment-experienced patients with undetectable viral load as a simplification strategy, allowing once-daily, two-pill regimen with three antiretroviral drug classes. Effectiveness was low in patients with detectable viral loads.

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