Switching to raltegravir in virologically suppressed in HIV-1-infected patients: a retrospective, multicenter, descriptive study.
OBJECTIVE
To describe the efficacy and tolerability of switching to raltegravir (RAL) in virologically suppressed HIV-1-infected patients during routine clinical practice.


METHODS
A total number of 263 subjects (189 men, median age 48.1 years) with HIV-1 RNA < 50 copies/mL for ≥ 6 months were switched to RAL (400 mg b.i.d). Reasons for change were toxicity (49.0%), drug interactions (6.1%) or convenience (28.6%) (switch from subcutaneous to oral treatment 22.4%, improvement of posology 3.4%). Patients were followed up to 24 months after switching to RAL. Primary end-points were tolerability and virological failure defined as two consecutive measures of HIV-1 RNA > 50 copies/mL.


RESULTS
After a median of 12.4 months (range 2.8-26.4 months), virological failure was observed in 6 (2.3%) patients (2.2 per 100 person-years [95%CI 0.9-4.6]), while AIDS occurred in 1, drug discontinuation in 4, 3 patients died and 10 were lost to follow-up. The median CD4+ T cell count increased from 460 cells/mm3 to 508.6 cells/mm3 (P < 0.001).


CONCLUSIONS
Switching to RAL in clinical practice was mainly driven by toxicity, convenience or interactions, they were well tolerated and secured virologic suppression in the vast majority of patients.
Infectious Disease Service, Hospital Universitari de Belvitge, L'Hospitalet de Llobregat, Barcelona, Spain. dpodzamczer@bellvitgehospital.cat
Daniel
D
Podzamczer
Esteban
E
Martínez
Pere
P
Domingo
Elena
E
Ferrer
Pompeyo
P
Viciana
Jordi
J
Curto
Maria-Jesús
MJ
Pérez-Elías
Antonio
A
Ocampo
Ignacio
I
Santos
Hernando
H
Knobel
Vicente
V
Estrada
Eugenia
E
Negredo
Ferrán
F
Segura
Joaquín
J
Portilla
Esteban
E
Ribera
Josefa
J
Galindo
Antonio
A
Antela
Jorge
J
Carmena
Manuel
M
Castaño
The Toral Study Group
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057915:Drug Substitution; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D019428:HIV Integrase Inhibitors / Q000627:therapeutic use*; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D011760:Pyrrolidinones / Q000627:therapeutic use*; D012367:RNA, Viral / Q000032:analysis; D000068898:Raltegravir Potassium; D012189:Retrospective Studies; D019562:Viral Load; D055815:Young Adult
D019428:HIV Integrase Inhibitors; D011760:Pyrrolidinones; D012367:RNA, Viral; D000068898:Raltegravir Potassium