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Clinical pharmacy
CP-053 Conditions of use of elvitegravir/cobicistat/emtricitabine/tenofovir in patients with HIV
  1. R Guerrero Bautista1,
  2. R Guerrero Bautista2,
  3. D Lacruz Guzman2,
  4. E Ferris Villanueva2,
  5. A García Márquez2,
  6. I Muñoz García2,
  7. A Charlotte Viney2,
  8. MS García Simón2,
  9. M Martínez Penella3,
  10. MC Mira Sirvent2
  1. 1Hospital General Universitario Santa Lucía, Cartagena, Spain
  2. 2Hospital General Universitario Santa Lucía, Farmacia Hospitalaria, Cartagena, Spain
  3. 3Hospital General Universitario Santa Lucía, Farmacia Hospotalaria, Cartagena, Spain

Abstract

Background Since 1981, the year of the first case of infection with HIV/AIDS, about 60 million people have been infected with the virus, and some 20 million have died. But since the appearance in 1995 of the so-called highly active antiretroviral therapy, there have been dramatic reductions observed in morbidity and mortality rates.

Purpose To evaluate the use of elvitegravir/cobicistat/emtricitabine/tenofovir (EVG/COBI/FTC/TDF) in patients with HIV and to check the adequacy of the prescription, as indicated by the HIV Therapy Group of the regional Pharmacy and Therapeutics Committee in their document ‘Terms of use of EVG/COBI/FTC/TDF’.

Material and methods Retrospective observational study in a tertiary hospital. Using the pharmaceutical management software program Savac, the total number of patients receiving EVG/COBI/FTC/TDF from October 2014 to October 2015 (approved use in the hospital) was obtained. The medical record programme Selene provided the following data: age, sex and previous comorbidities. Before initiating a naïve or treatment switch with EVG/COBI/FTC/TDF, the use was approved following the guidelines prepared by the HIV Therapy Group.

Results 28 patients, 19 (68%) men and 9 (32%) women with a mean age of 49 years, were included in the study. 5 naïve patients were identified and the rest were treatment changes. The most common previous treatment schemes were: tenofovir+efavirenz (25%), tenofovir+etravirine (14.3%), tenofovir+darunavir+ritonavir (7%) and lopinavir/ritonavir+tenofovir (7%).

The most common comorbidities inducing treatment switch were hepatitis C virus (23%), dyslipidaemia (21%), hypertension (17%), hypercholesterolaemia (7%), adherence problems (3%) and vitamin D deficiency (1%).

Conclusion According to the document prepared by the regional HIV Therapy Group, its use is preferable in non-compliant patients, prioritising simplicity to prevent selected resistance. In our study, the most common comorbidity that led to its use as treatment was hepatitis C virus. Starting or changing treatment to EVG/COBI/FTC/TDF complied with the document prepared by the HIV Group in all cases.

https://doi.org/10.1136/ejhpharm-2016-000875.53

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