Use of rilpivirine in HIV-1 infected individuals in routine clinical practice from 2012 to 2017 in France
Résumé
We assessed virological outcomes of rilpivirine use in France from 2012 to 2017, in three groups of people living with HIV (PLHIV):(1) antiretroviral (ARV)-naïve PLHIV;(2) ARVexperienced PLHIV switching to rilpivirine while failing therapy; and (3) ARV-experienced PLHIV switching to rilpivirine while virologically controlled. Methods: Virological success (VS) was defined as a plasma HIV-1 viral load (VL)<50 copies/mL and virological failure (VF) as two consecutive VL>50 copies/mL or one VL>50 copies/mL followed by a treatment switch prior to the next VL measurement. The cumulative incidence of VS was assessed considering rilpivirine discontinuation, loss to follow-up, and death as competing risks, while estimates of cumulative incidence of VF accounted for loss to follow-up and death. Results: Among the 2166 ARV-naïve PLHIV initiating rilpivirine, the four-year cumulative incidence of VS was 91.0% and was associated with baseline VL. Among the 2125 ARVexperienced PLHIV switching to rilpivirine while failing therapy, the four-year cumulative incidence of VS was 82.5% and was associated with lower VL, higher CD4, and less than three prior ARVs. Among the 11828 ARV-experienced PLHIV switching to rilpivirine while virologically controlled, the four-year cumulative incidence of VF was 9.6%. The risk of VF was lower among MSM, for PLHIV with CD4≥500/mm 3 , without a prior AIDS event, or with a longer VL suppression at baseline. Conclusion: Rilpivirine-containing regimens yielded high rates of viral suppression in most participants, while it was ineffective when used outside the marketing authorization in naïve participants.
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Potard et al. - 2021 - Use of rilpivirine in HIV-1-infected individuals i.pdf (471 Ko)
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