People with HIV who have experienced virologic failure while taking an integrase inhibitor have an excellent chance of success through treatment with the antiretroviral (ARV) Tivicay (dolutegravir), aidsmap reports.
Tivicay is a next-generation integrase inhibitor and is included in the single-tablet regimens Juluca (dolutegravir/rilpivirine) and Triumeq (dolutegravir/abacavir/lamivudine). The other two integrase inhibitors on the market are Vitekta (elvitegravir) and Isentress (raltegravir).
Publishing their findings in the Journal of Clinical Virology, Italian researchers retrospectively analyzed data on 89 people with HIV who had had experience with numerous ARV regimens and who had experienced virologic failure on an integrase inhibitor regimen before switching to a Tivicay-based regimen. The study authors culled the data from the Antiviral Response Cohort Analysis database.
Nineteen months after starting Tivicay, 89 percent (79) of the cohort members were still on the drug; all of them had a fully suppressed viral load. Ten people stopped taking the drug a median three months after starting. Half (5) of those who stopped taking Tivicay had a fully suppressed viral load at the time.
The study authors determined that factors associated with having a detectable viral load at the end of the study’s follow-up period included having a non-B HIV-1 subtype and a detectable viral load when starting Tivicay, which increased the risk by a respective factor of 5.77-fold and 4.5-fold. However, the finding about starting with a detectable viral load wasn’t quite statistically significant, meaning the apparent association with winding up with a detectable viral load at the end of follow-up may have been driven by chance.
Otherwise, factors associated with a greater likelihood of having a fully suppressed viral load at the end of the study’s follow-up included having a lowest-ever CD4 cell count above 200, having taken at least 10 previous ARV regimens and starting Tivicay with mutations to HIV that are associated with integrase inhibitor resistance.
To read the aidsmap article, click here.
To read the study abstract, click here.