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Efficacy and safety of abacavir/lamivudine plus rilpivirine as a first-line regimen in treatment-naïve HIV-1 infected adults.
AIDS Res Ther. 2020 May 21; 17(1):23.AR

Abstract

BACKGROUND

The anti-retroviral combination of abacavir/lamivudine plus rilpivirine (ABC/3TC/RPV) is not recommended by international guidelines as the first-line regimen. However, it is potent, well-tolerated, and affordable, especially in resource-limited settings. This study evaluates the efficacy and safety of ABC/3TC/RPV as an initial regimen for treatment-naïve HIV-1 infected patients.

METHODS

A retrospective study was conducted in the largest HIV care centre in Singapore, with data collected June 2011 to September 2017. All treatment-naïve HIV-1 infected adults prescribed ABC/3TC as part of their initial anti-retroviral therapy regimen were included. The third drug was a non-nucleoside reverse-transcriptase inhibitor (NNRTI) such as RPV or efavirenz (EFV), or boosted protease-inhibitor (PI). Patients were followed up for 48 weeks. The primary end-point was the percentage of patients achieving virologic suppression, analysed using on-treatment analysis. Secondary outcomes included CD4-count change, treatment discontinuation and treatment-related adverse events.

RESULTS

170 patients were included in the study, 66 patients in the RPV group, 104 patients in the comparator group (EFV or boosted PI). 96% (n = 24) in the RPV group and 87% (n = 26) in the comparator group achieved viral suppression at 48 weeks (p = 0.28). Median (interquartile range) time to viral suppression was similar: 17 (14-24) weeks in the RPV group, and 21 (13-26) weeks in the comparator group. There were no statistically significant differences in the CD4 count between the two groups. 14% (n = 9) of patients on RPV discontinued treatment before 48 weeks, compared to 30% (n = 31) from the comparator group (p = 0.053). Of these, 23 discontinuations were due to drug adverse effects, and only 1 attributed to RPV (p < 0.01). One patient in each group had virologic failure.

CONCLUSION

RPV is effective, safe and considerably more tolerable than compared to NNRTI or boosted PI in ABC/3TC-containing regimens for treatment-naïve patients. It offers an affordable and attractive option, especially in resource-limited settings.

Authors+Show Affiliations

Tan Tock Seng Hospital, Singapore, Singapore.Office of Clinical Epidemiology, Analytics and Knowledge, Tan Tock Seng Hospital, Singapore, Singapore.National Centre for Infectious Diseases, Singapore, Singapore. Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore. Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.National Centre for Infectious Diseases, Singapore, Singapore. Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.National Centre for Infectious Diseases, Singapore, Singapore. Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore. Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.National Centre for Infectious Diseases, Singapore, Singapore. Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore. Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.National Centre for Infectious Diseases, Singapore, Singapore. chen_seong_wong@ncid.sg. Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore. chen_seong_wong@ncid.sg. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. chen_seong_wong@ncid.sg.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32438914

Citation

Ho, Sharlene, et al. "Efficacy and Safety of Abacavir/lamivudine Plus Rilpivirine as a First-line Regimen in Treatment-naïve HIV-1 Infected Adults." AIDS Research and Therapy, vol. 17, no. 1, 2020, p. 23.
Ho S, Wong JG, Ng OT, et al. Efficacy and safety of abacavir/lamivudine plus rilpivirine as a first-line regimen in treatment-naïve HIV-1 infected adults. AIDS Res Ther. 2020;17(1):23.
Ho, S., Wong, J. G., Ng, O. T., Lee, C. C., Leo, Y. S., Lye, D. C. B., & Wong, C. S. (2020). Efficacy and safety of abacavir/lamivudine plus rilpivirine as a first-line regimen in treatment-naïve HIV-1 infected adults. AIDS Research and Therapy, 17(1), 23. https://doi.org/10.1186/s12981-020-00272-5
Ho S, et al. Efficacy and Safety of Abacavir/lamivudine Plus Rilpivirine as a First-line Regimen in Treatment-naïve HIV-1 Infected Adults. AIDS Res Ther. 2020 May 21;17(1):23. PubMed PMID: 32438914.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy and safety of abacavir/lamivudine plus rilpivirine as a first-line regimen in treatment-naïve HIV-1 infected adults. AU - Ho,Sharlene, AU - Wong,Joshua Guoxian, AU - Ng,Oon Tek, AU - Lee,Cheng Chuan, AU - Leo,Yee Sin, AU - Lye,David Chien Boon, AU - Wong,Chen Seong, Y1 - 2020/05/21/ PY - 2020/01/22/received PY - 2020/05/04/accepted PY - 2020/5/23/entrez PY - 2020/5/23/pubmed PY - 2020/5/23/medline KW - Abacavir KW - Antiretroviral KW - HIV KW - Treatment-naïve KW - Rilpivirine SP - 23 EP - 23 JF - AIDS research and therapy JO - AIDS Res Ther VL - 17 IS - 1 N2 - BACKGROUND: The anti-retroviral combination of abacavir/lamivudine plus rilpivirine (ABC/3TC/RPV) is not recommended by international guidelines as the first-line regimen. However, it is potent, well-tolerated, and affordable, especially in resource-limited settings. This study evaluates the efficacy and safety of ABC/3TC/RPV as an initial regimen for treatment-naïve HIV-1 infected patients. METHODS: A retrospective study was conducted in the largest HIV care centre in Singapore, with data collected June 2011 to September 2017. All treatment-naïve HIV-1 infected adults prescribed ABC/3TC as part of their initial anti-retroviral therapy regimen were included. The third drug was a non-nucleoside reverse-transcriptase inhibitor (NNRTI) such as RPV or efavirenz (EFV), or boosted protease-inhibitor (PI). Patients were followed up for 48 weeks. The primary end-point was the percentage of patients achieving virologic suppression, analysed using on-treatment analysis. Secondary outcomes included CD4-count change, treatment discontinuation and treatment-related adverse events. RESULTS: 170 patients were included in the study, 66 patients in the RPV group, 104 patients in the comparator group (EFV or boosted PI). 96% (n = 24) in the RPV group and 87% (n = 26) in the comparator group achieved viral suppression at 48 weeks (p = 0.28). Median (interquartile range) time to viral suppression was similar: 17 (14-24) weeks in the RPV group, and 21 (13-26) weeks in the comparator group. There were no statistically significant differences in the CD4 count between the two groups. 14% (n = 9) of patients on RPV discontinued treatment before 48 weeks, compared to 30% (n = 31) from the comparator group (p = 0.053). Of these, 23 discontinuations were due to drug adverse effects, and only 1 attributed to RPV (p < 0.01). One patient in each group had virologic failure. CONCLUSION: RPV is effective, safe and considerably more tolerable than compared to NNRTI or boosted PI in ABC/3TC-containing regimens for treatment-naïve patients. It offers an affordable and attractive option, especially in resource-limited settings. SN - 1742-6405 UR - https://www.unboundmedicine.com/medline/citation/32438914/Efficacy_and_safety_of_abacavir/lamivudine_plus_rilpivirine_as_a_first-line_regimen_in_treatment-naïve_HIV-1_infected_adults L2 - https://aidsrestherapy.biomedcentral.com/articles/10.1186/s12981-020-00272-5 DB - PRIME DP - Unbound Medicine ER -
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