Effectiveness of etravirine-based therapy for treatment-experienced HIV-infected patients

  • Gloria Huerta García National Medical Center “Siglo XXI”, IMSS, Distrito Federal, Distrito Federal, Mexico
  • José Antonio Mata-Marín National Medical Center “La Raza”, IMSS, Distrito Federal, Mexico City, Mexico
  • Juan Carlos Domínguez-Hermosillo National Medical Center “La Raza”, IMSS, Distrito Federal, Mexico City, Mexico
  • Marcelino Chavez-García IMSS, Monterrey, NL, Mexico
  • Marco Issac Banda-Lara AIDS clinic, General Hospital No. 2, IMSS San Luis Potosí, S.L.P, Mexico
  • Nohemi Nuñez-Rodríguez AIDS clinic, General Hospital No. 24, IMSS, Distrito Federal, Mexico
  • Javier Enrique Cruz-Herrera AIDS clinic, General Hospital No.72, IMSS, Distrito Federal, México
  • Jorge Luis Sandoval-Ramírez National Medical Center “La Raza”, IMSS, Distrito Federal, Mexico City, Mexico
  • Alfredo Villagómez-Ruiz AIDS clinic, General Hospital, Culiacán, Sinaloa, IMSS, Mexico
  • Bulmaro Manjarrez-Tellez National Medical Center “La Raza”, IMSS, Distrito Federal, Mexico City, Mexico
  • Jesús Enrique Gaytan-Martínez National Medical Center “La Raza”, IMSS, Distrito Federal, Mexico City, Mexico
Keywords: etravirine, treatment-experienced, virologic suppression, drug resistance, HIV-1 RNA, virological outcome

Abstract

Introduction: Treatment options are limited for HIV-1-infected individuals who have received extensive previous antiretroviral therapy. ETV has shown significant clinical benefits in treatment-experienced HIV-1+ patients with antiretroviral resistance. The aim of this study was to evaluate the effectiveness of ETV plus optimized background regimen in real-life conditions in a cohort of highly HIV-1 antiretroviral-experienced patients.

Methodology: Retrospective cohort of treatment-experienced HIV-1-infected adults with virological failure who started therapy with an ETV-containing regimen. The effectiveness was evaluated using HIV-1 RNA viral load and changes in CD4+ cell count after 48 weeks of treatment.

Results: Forty-two patients ≥ 16 years of age were included; 74% were men, and the median age was 45 years (IQR 41–53). All participants had prior non-nucleoside reverse transcriptase inhibitor use (55% nevirapine, 83%, efavirenz, and 28% both). Baseline median HIV-1 RNA viral load was 15,598 copies/mL (IQR 2651–84,175) and CD4+ cell count was 276 cells/mL (IQR 155–436). After 48 weeks of treatment, 90.5% (95% CI 78–96) of patients had HIV-1 RNA viral load < 200 copies/mL and 76% (95% CI 61–86) had < 50 copies/mL. CD4+ cell counts increased from baseline to 48 weeks of treatment to a median of 407 cells/mL (IQR 242–579); p < 0.001. Virological outcome was associated with virological failure at baseline HIV-1 RNA viral load ≥100,000 copies/mL (OR 7.6; 95% CI 1.2–44.80; p = 0.025).

Conclusions: Our study provides clinically important evidence of the effectiveness and safety of ETV in highly antiretroviral-experienced HIV-1-infected patients.

Author Biography

Gloria Huerta García, National Medical Center “Siglo XXI”, IMSS, Distrito Federal, Distrito Federal, Mexico
MD. Infectious diseases
Published
2016-06-30
How to Cite
1.
Huerta García G, Mata-Marín JA, Domínguez-Hermosillo JC, Chavez-García M, Banda-Lara MI, Nuñez-Rodríguez N, Cruz-Herrera JE, Sandoval-Ramírez JL, Villagómez-Ruiz A, Manjarrez-Tellez B, Gaytan-Martínez JE (2016) Effectiveness of etravirine-based therapy for treatment-experienced HIV-infected patients. J Infect Dev Ctries 10:605-611. doi: 10.3855/jidc.7512
Section
Original Articles