Durability of Integrase STrand Inhibitor (InSTI)-based regimen in geriatric people living with HIV in the GEPPO cohort.

To investigate the durability of the first integrase inhibitor-based regimen in a HIV geriatric multicentric prospective cohort and to explore the reasons of regimen discontinuation. This is an analysis conducted on the Geriatric Patients Living with HIV/AIDS (GEPPO) cohort, an Italian prospective observational multicentre cohort of people living with HIV with 65 years of age or more. The analysis was performed using R (version 4.0.2). The tests performed were two sided assuming a 5% significance level (Kruskal-Wallis test, Chi-squared test, log-rank test and a Cox Proportional Hazard model). The proportion of participants discontinuing the three regimens was displayed using cumulative curves. Among 1531 patients enrolled between 2017 and 2019 in the GEPPO cohort, we included 822 participants in this analysis. At baseline, median age was 69.8, the immunovirological profile good, multimorbidity was present in 42.3% of participants, while 27.4% were on polypharmacy. Overall, 483, 243 and 96 participants received DTG, RAL and EVG/c respectively as first InSTI. At the end of the follow up 6.4%, 21.1% and 22.9% participants discontinued DTG, RAL and EVG/c respectively. Using a log-rank test, EVG showed a significantly lower durability than DTG (p<0.001) or RAL (p 0.05) or both, DTG and RAL (p<0.001). Among participants who discontinued their regimen we found 0 virological failure and 56.7% simplification/deprescription. The three integrase inhibitors considered showed a good durability and no virological failures in geriatric patients such as those enrolled in the GEPPO cohort when used in a two or three drug regimen.

Déclaration de conflit d'intérêts

All the authors received nonspecific funding for this work. Emanuele Focà received research grants from Gilead and ViiV, speaker’s honoraria from Gilead, Janssen- Cilag, Menarini, MSD and ViiV and attendee advisory boards of Gilead, Janssen-Cilag and ViiV. Andrea Calcagno received research grants from Gilead and ViiV and speaker’s honoraria from Gilead, Insmed, Janssen-Cilag, MSD and ViiV. Giuseppe Vittorio De Socio attended advisory board of Janssen-Cilag and ViiV. Giovanni Guaraldi received research grant and speaker honorarium from Gilead, ViiV, MERCK and Jansen. He attended advisory boards of Gilead, ViiV and MERCK. Giordano Madeddu received speaker and advisor fees from Gilead Sciences, Janssen, Merck Sharp and Dohme and ViiV. Benedetto Maurizio Celesia received research grants from Gilead and ViiV, speaker’s honoraria from Gilead, Janssen-Cilag, MSD and ViiV and attendee advisory boards of Gilead, Janssen-Cilag, MSD, Mylan and ViiV. Silvia Nozza received research grants from Gilead, speaker’s honoraria from Gilead, Janssen-Cilag, MSD and ViiV The other Authors have no conflicts to disclose. This does not alter our adherence to PLOS ONE policies on sharing data and materials.