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Rapid initiation of bictegravir/emtricitabine/tenofovir alafenamide as first-line therapy in HIV infection. A prospective study.
Ugarte, Ainoa; De La Mora, Lorena; De Lazzari, Elisa; Chivite, Iván; Fernández, Emma; Inciarte, Alexy; Laguno, Montserrat; Ambrosioni, Juan; Solbes, Estela; Berrocal, Leire; González-Cordón, Ana; Martínez-Rebollar, María; Foncillas, Alberto; Calvo, Júlia; Blanco, José Luis; Martínez, Esteban; Mallolas, Josep; Torres, Berta.
Afiliación
  • Ugarte A; HIV Unit, Infectious Diseases Service, Hospital Clinic of Barcelona, Villarroel Street 170, Barcelona 08036, Spain.
  • De La Mora L; University of Barcelona, Barcelona, Spain.
  • De Lazzari E; HIV Unit, Infectious Diseases Service, Hospital Clinic of Barcelona, Villarroel Street 170, Barcelona 08036, Spain.
  • Chivite I; University of Barcelona, Barcelona, Spain.
  • Fernández E; HIV Unit, Infectious Diseases Service, Hospital Clinic of Barcelona, Villarroel Street 170, Barcelona 08036, Spain.
  • Inciarte A; University of Barcelona, Barcelona, Spain.
  • Laguno M; CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Carlos III, Madrid, Spain.
  • Ambrosioni J; HIV Unit, Infectious Diseases Service, Hospital Clinic of Barcelona, Villarroel Street 170, Barcelona 08036, Spain.
  • Solbes E; University of Barcelona, Barcelona, Spain.
  • Berrocal L; HIV Unit, Infectious Diseases Service, Hospital Clinic of Barcelona, Villarroel Street 170, Barcelona 08036, Spain.
  • González-Cordón A; HIV Unit, Infectious Diseases Service, Hospital Clinic of Barcelona, Villarroel Street 170, Barcelona 08036, Spain.
  • Martínez-Rebollar M; University of Barcelona, Barcelona, Spain.
  • Foncillas A; HIV Unit, Infectious Diseases Service, Hospital Clinic of Barcelona, Villarroel Street 170, Barcelona 08036, Spain.
  • Calvo J; University of Barcelona, Barcelona, Spain.
  • Blanco JL; CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Carlos III, Madrid, Spain.
  • Martínez E; HIV Unit, Infectious Diseases Service, Hospital Clinic of Barcelona, Villarroel Street 170, Barcelona 08036, Spain.
  • Mallolas J; University of Barcelona, Barcelona, Spain.
  • Torres B; CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Carlos III, Madrid, Spain.
J Antimicrob Chemother ; 79(9): 2343-2353, 2024 Sep 03.
Article en En | MEDLINE | ID: mdl-39045754
ABSTRACT

INTRODUCTION:

Rapid initiation of ART after HIV diagnosis is recommended for individual and public health benefits. However, certain clinical and ART-related considerations hinder immediate initiation of therapy.

METHODS:

An open-label, single-arm, single-centre 48-week prospective clinical trial involving ART-naïve HIV-diagnosed adults who started bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) within a week from the first hospital visit, before the availability of baseline laboratory and genotype results. The primary aim was to determine the proportion of people with at least one condition that would hinder immediate initiation of any recommended ART regimen other than BIC/FTC/TAF. Clinicaltrials.gov NCT04416906.

RESULTS:

We included 100

participants:

79% men, 64% from Latin America, median age 32 years. According to European AIDS Clinical Society (EACS) and US Department of Health and Human Services 2023 guidelines, 11% (95%CI 6; 19) of participants had at least one condition that made any ART different from BIC/FTC/TAF less appropriate for a rapid ART strategy. Seventy-nine percent of the people started BIC/FTC/TAF within the first 48 hours of their first hospital visit. There were 16 early discontinuations (11 lost to follow-up). By week 48, 92% (95%CI 86; 98) of the participants of the ITT population with observed data achieved viral suppression. Eight grade 3-4 adverse events (AEs), five serious AEs and six ART-related AEs were identified. Adherence remained high.

CONCLUSIONS:

BIC/FTC/TAF is an optimal treatment for rapid initiation of ART. However, additional strategies to improve retention in care must be implemented.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Piridonas / Infecciones por VIH / Fármacos Anti-VIH / Alanina / Tenofovir / Emtricitabina Idioma: En Revista: J Antimicrob Chemother Año: 2024 Tipo del documento: Article País de afiliación: España Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Piridonas / Infecciones por VIH / Fármacos Anti-VIH / Alanina / Tenofovir / Emtricitabina Idioma: En Revista: J Antimicrob Chemother Año: 2024 Tipo del documento: Article País de afiliación: España Pais de publicación: Reino Unido