Background The new combination tenofovir/emtricitabine/rilpivirine (TDF/FTC/RPV) produces fewer adverse central nervous system effects, encouraging better adherence while being as effective as the tenofovir/emtricitabine/efavirenz (TDF/FTC/EFV) combination.
Purpose To analyse the progress of patients with HIV-1 infection who changed treatment from TDF/FTC/EFV to TDF/FTC/RPV. To evaluate the maintenance of viral suppression and the adherence.
Material and methods Retrospective observational study. Study duration: 1 year. Patients were switched to treatment with TDF/FTC/RPV. We excluded patients who had not been treated previously with TDF/FTC/EFV and treatment-naive patients. We developed a database with viral load (VL) and CD4 T lymphocyte level (LTCD4) before switching and after 6 months of treatment. We also considered the adherence to the new antiretroviral by number and date of prescriptions dispensed.
Results In the study period, 149 patients were treated with TDF/FTC/RPV. Of these, 50.3% (75) had previously been treated with TDF/FTC/EFV. The remaining patients were excluded for not meeting the study criteria. 94.7% (71) of the patients maintained virological suppression to less than 37 copies/ml. Three patients with 523, 400, 64.04 and 48.58 copies/ml, respectively, were able to achieve a VL of fewer than 37 copies/ml after 6 months treatment with TDF/FTC/RPV. The LTCD4 level increased or remained at figures close to those already obtained from previous treatment in all patients. All patients maintained their adherence due to continuing with a single tablet daily, having a better side effect profile.
Conclusion In patients with HIV infection, change of treatment from TDF/FTC/EFV to TDF/FTC/RPV proved effective, and maintained or decreased the levels of VL. The results obtained in this study are similar to Nelson et al’s study, which concludes that we must identify patients with adverse effects to EFV so they can benefit from TDF/FTC/RPV.1
References and/or Acknowledgements
Nelson M, et al. Multicentre Open-label study of switching from Atripla to Eviplera for possible efavirenz associated CNS toxicity. 53rd ICAAC2013. AbstractH-672b
References and/or AcknowledgementsNo conflict of interest.
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