Background Rilpivirine/Emtricitabine/Tenofovir (RPV/FTC/TDF) is a single tablet regimen recommended for treatment-naïve HIV patients with baseline viral load (VL) < 100.000 copies/mL.¹

Purpose To analyse the usage profile, effectiveness and safety of RPV/FTC/TDF.

Material and methods Retrospective study conducted in a Primary Hospital between May 2013–Sept 2014. Patients included were those with HIV infection who started RPV/FTC/TDF treatment. Data were collected from electronic medical records: Demographics, previous antiretroviral therapy (ART), reason for treatment, immunovirological status, laboratory data (VL, CD4, c-LDL, Total Cholesterol) and adverse effects before/after start of RPV/FTC/TDF. Adherence was assessed by the dispensing records and the Simplified Medication Adherence Questionnaire (SMAQ) (patients were considered adherent with scores over 95%).

Results RPV/FTC/TDF was initiated in 21/390 (5%) patients with ART. Age (years): 45 (range: 31–70); Male: 14/21 (68%). Patients with previous ART: EFV/FTC/TDF: 7; FTC/TDF/ATV/r: 2; 3TC/AZT/NVP: 1; 3TC/AZT/LPV/r: 1; ABC/AZT/LPV/r: 1; TDF/FTC/NVP: 1; FTC/TDF/ETV: 1; FTC/TDF/DRV/r: 1; DRV/r: 1; FTC/TDF: 1. Reasons for prescription: 17 ART-experienced (81%) and 4 ART-naïve (19%). Pretreated reasons: 9 (53%) simplifications, 6 (36%) to avoid previous ART toxicity (EFV: 4, Protease Inhibitors: 2) and 2 (11%) others. Three patients were withdrawn (low adherence: 2, pantoprazole interaction: 1). Pre-treatment data: Adherence > 95% 7/17 (41%), VL < 50 copies/mL: 8/21 (38%), pretreated VL < 50 copies/mL: 8/17 (47%), CD4: 507, c-LDL: 114 mg/dL, Total cholesterol: 180 mg/dL. Post-treatment data: Adherence > 95%: 17/21 (80%), patients simplified to RPV/FTC/TDF who achieved >95% adherence: 6/9 (66%), VL < 50 copies/mL: 18/21 (85%), pretreated VL < 50 copies/mL: 16/17 (94%), CD4: 563, c-LDL: 102 mg/dL, Total cholesterol: 164 mg/dL. Reduction in c-LDL and Total Cholesterol was 10% and 9% respectively, which is consistent with previous studies.² Only one patient experienced headaches during the first week with RPV/FTC/TDF.

Conclusion RPV/FTC/TDF was used primarily as a strategy for simplification and to avoid ART toxicity, mainly due to EFV. All patients had undetectable VL, improved adherence (+39%), effectiveness (11% increase in CD4) and treatment was well tolerated. Lipid profile was improved too.

References

1. EACS Guidelines Version 7.02. June 2014

2. Sharma M, Saravolatz LD. J Antimicrob Chemothe 2013;(68):250–6

ReferencesNo conflict of interest.