Clinical experience with integrase inhibitors in HIV-2-infected individuals in Spain.

Adolescent Adult CD4 Lymphocyte Count Drug Resistance, Viral / genetics Female HIV Infections / drug therapy HIV Integrase Inhibitors / pharmacology HIV-2 / drug effects Humans Male Microbial Sensitivity Tests Middle Aged Mutation RNA, Viral / blood Retrospective Studies Spain Treatment Failure

Journal

The Journal of antimicrobial chemotherapy

ISSN: 1460-2091

Titre abrégé: J Antimicrob Chemother

Pays: England

ID NLM: 7513617

Informations de publication

Date de publication:
01 05 2019

Historique:

received: 22 10 2018

revised: 26 12 2018

accepted: 31 12 2018

pubmed: 13 2 2019

medline: 30 7 2020

entrez: 13 2 2019

Statut: ppublish

Résumé

HIV-2 is a neglected virus despite estimates of 1-2 million people being infected worldwide. The virus is naturally resistant to some antiretrovirals used to treat HIV-1 and therapeutic options are limited for patients with HIV-2. In this retrospective observational study, we analysed all HIV-2-infected individuals treated with integrase strand transfer inhibitors (INSTIs) recorded in the Spanish HIV-2 cohort. Demographics, treatment modalities, laboratory values, quantitative HIV-2 RNA and CD4 counts as well as drug resistance were analysed. From a total of 354 HIV-2-infected patients recruited by the Spanish HIV-2 cohort as of December 2017, INSTIs had been given to 44, in 18 as first-line therapy and in 26 after failing other antiretroviral regimens. After a median follow-up of 13 months of INSTI-based therapy, undetectable viraemia for HIV-2 was achieved in 89% of treatment-naive and in 65.4% of treatment-experienced patients. In parallel, CD4 gains were 82 and 126 cells/mm3, respectively. Treatment failure occurred in 15 patients, 2 being treatment-naive and 13 treatment-experienced. INSTI resistance changes were recognized in 12 patients: N155H (5), Q148H/R (3), Y143C/G (3) and R263K (1). Combinations based on INSTIs are effective and safe treatment options for HIV-2-infected individuals. However, resistance mutations to INSTIs are selected frequently in failing patients, reducing the already limited treatment options.

Sections du résumé

BACKGROUND

METHODS

In this retrospective observational study, we analysed all HIV-2-infected individuals treated with integrase strand transfer inhibitors (INSTIs) recorded in the Spanish HIV-2 cohort. Demographics, treatment modalities, laboratory values, quantitative HIV-2 RNA and CD4 counts as well as drug resistance were analysed.

RESULTS

From a total of 354 HIV-2-infected patients recruited by the Spanish HIV-2 cohort as of December 2017, INSTIs had been given to 44, in 18 as first-line therapy and in 26 after failing other antiretroviral regimens. After a median follow-up of 13 months of INSTI-based therapy, undetectable viraemia for HIV-2 was achieved in 89% of treatment-naive and in 65.4% of treatment-experienced patients. In parallel, CD4 gains were 82 and 126 cells/mm3, respectively. Treatment failure occurred in 15 patients, 2 being treatment-naive and 13 treatment-experienced. INSTI resistance changes were recognized in 12 patients: N155H (5), Q148H/R (3), Y143C/G (3) and R263K (1).

CONCLUSIONS

Combinations based on INSTIs are effective and safe treatment options for HIV-2-infected individuals. However, resistance mutations to INSTIs are selected frequently in failing patients, reducing the already limited treatment options.

Identifiants

DOI: 10.1093/jac/dkz007 PMID: 30753573

pubmed: 30753573

pii: 5315652

doi: 10.1093/jac/dkz007

doi:

Substances chimiques

HIV Integrase Inhibitors 0

RNA, Viral 0

Types de publication

Journal Article Observational Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

Pagination

1357-1362

Investigateurs

C Rodríguez (C)

M Vera (M)

J Del Romero (J)

G Marcaida (G)

M D Ocete (MD)

E Caballero (E)

A Aguilera (A)

R Benito (R)

R Ortiz de Lejarazu (R)

S Rojo (S)

J M Eirós (JM)

C Ramos (C)

J García (J)

I Paz (I)

M Trigo (M)

J Diz (J)

M García-Campello (M)

M Rodríguez-Iglesias (M)

A Hernández-Betancor (A)

A M Martín (AM)

J M Ramos (JM)

A Gimeno (A)

V Sánchez (V)

C Gómez-Hernando (C)

G Cilla (G)

E Pérez-Trallero (E)

L Fernández-Pereira (L)

J Niubó (J)

M Hernández (M)

A M López-Lirola (AM)

J L Gómez-Sirvent (JL)

L Force (L)

J Cabrera (J)

S Pérez (S)

L Morano (L)

C Raya (C)

A González-Praetorius (A)

C Cifuentes (C)

M Peñaranda (M)

M C Nieto (MC)

J M Montejo (JM)

L Roc (L)

I Viciana (I)

A B Lozano (AB)

E Fernández-Fuertes (E)

J M Fernández (JM)

I García-Bermejo (I)

G Gaspar (G)

R Téllez (R)

M Górgolas (M)

P Miralles (P)

L Pérez (L)

M Valeiro (M)

T Aldamiz (T)

N Margall (N)

A Suárez (A)

I Rodríguez-Avial (I)

S Requena (S)

L Benítez-Gutiérrez (L)

V Cuervas-Mons (V)

C de Mendoza (C)

P Barreiro (P)

V Soriano (V)

Informations de copyright

© The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.