This study aimed to evaluate the efficacy, tolerability and potential savings of combined antiretroviral therapy (cART) simplification from an unboosted protease inhibitor (PI) regimen with atazanavir or fosamprenavir to a single-tablet regimen (STR) based on rilpivirine/emtricitabine/tenofovir disoproxil fumarate (RPV/FTC/TDF) among HIV-1-infected patients with HIV-1 RNA <50 copies/mL. This was a retrospective, multicentre, open-label, 12-week trial. Plasma HIV-1-RNA levels, CD4+ cell counts, cholesterol, triglycerides, bilirubin, glycaemia, creatinine and physical examination were performed at baseline and at scheduled follow-up. All patient costs were calculated and were estimated for 52 weeks of therapy. Fifty-one patients were enrolled [28 male (54.9%)]. At baseline, 30 patients (58.8%) were treated with FTC/TDF, 20 (39.2%) with abacavir/lamivudine and 1 (2.0%) with lamivudine/zidovudine. Thirty-three patients (64.7%) received atazanavir. All patients maintained HIV-RNA <50 copies/mL; the median CD4+ cell count remained stable. Mean triglycerides decreased from 124 mg/dL (range, 39–625) at enrolment to 108.7 mg/dL (range, 39–561) at study end (P = 0.25). At baseline, mean cholesterol was 172.8 ± 38.1 mg/dL and decreased to 161.9 ± 38.6 mg/dL (P = 0.038); likewise, median total bilirubin decreased from 1.07 mg/dL (range, 0.2–4.7) to 0.6 mg/dL (range, 0.13–3.1) (P < 0.001). cART-related annual cost reduction with a STR was €3155.47 per patient (−24%). Non-cART patient management expenses were €402.68 vs. €299.10 for atazanavir or fosamprenavir and STR regimens, respectively. Switching to RPV/FTC/TDF from an unboosted PI in virologically suppressed HIV-infected patients is safe and is associated with a reduction in triglycerides, cholesterol and cART-related costs.
Switch from unboosted protease inhibitor to a single-tablet regimen containing rilpivirine improves cholesterol and triglycerides / A. Di Biagio, N. Riccardi, L. Taramasso, A. Capetti, G. Cenderello, A. Signori, P. Vitiello, M. Guerra, G.V. de Socio, G. Cassola, T. Quirino, C. Viscoli. - In: INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS. - ISSN 0924-8579. - 48:5(2016 Nov), pp. 551-554.
|Titolo:||Switch from unboosted protease inhibitor to a single-tablet regimen containing rilpivirine improves cholesterol and triglycerides|
RICCARDI, NICCOLO' (Corresponding)
|Parole Chiave:||Cholesterol; Rilpivirine; Ritonavir-sparing; Switch; Triglycerides; Unboosted protease inhibitor; Adult; Aged; Aged, 80 and over; Anti-HIV Agents; CD4 Lymphocyte Count; Cholesterol; Dyslipidemias; Female; HIV Infections; HIV Protease Inhibitors; HIV-1; Health Care Costs; Humans; Male; Middle Aged; Pilot Projects; RNA, Viral; Retrospective Studies; Rilpivirine; Tablets; Treatment Outcome; Triglycerides; Viral Load; Young Adult|
|Settore Scientifico Disciplinare:||Settore MED/17 - Malattie Infettive|
|Data di pubblicazione:||nov-2016|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/j.ijantimicag.2016.07.009|
|Appare nelle tipologie:||01 - Articolo su periodico|