Switching to an etravirine-containing regimen due to drug intolerance in clinical practice.
BACKGROUND
Drug intolerance is one of the main reasons for switching antiretroviral therapy in HIV-infected patients. Etravirine (ETR) has demonstrated good tolerability in clinical trials and may be an option for patients who switch therapy due to adverse events.


METHODS
We retrospectively reviewed all patients who had switched to an ETR-containing regimen in our center due to side effects. Virological suppression, ETR discontinuation, and reasons for discontinuation were studied.


RESULTS
A total of 78 patients started treatment with ETR in our center due to previous regimen toxicity. Most of them were men (83.3%), and the median time of infection was 14 years (IQR, 6.5-20 years). HIV RNA was <35 copies/mL in 88.3% of patients, although 33% had archived non-nucleos(t)ide reverse transcriptase inhibitor (NNRTI) mutations that did not compromise ETR efficacy. Efavirenz was the drug most often replaced (38.5%), followed by atazanavir (20.5%) and lopinavir (6.4%). The fixed combination of Trizivir was changed in another 10.3% of patients. After a median follow-up of 14 months (IQR, 6-23), the rate of virologic suppression was 79.5% and 98.4% in intention-to-treat and on-treatment analysis, respectively. Seven patients discontinued treatment due to adverse events (3 gastrointestinal disturbances, 2 rashes, 1 swelling, and 1 neuropathy). ETR was combined with 2 nucleos(t)ide analogues in 75.4% of patients.


CONCLUSIONS
In HIV patients who report drug side effects, switching to an ETR-containing regimen is a safe strategy in terms of virological suppression and toxicity.
Infectious Disease Department, Hospital Carlos III, Madrid, Spain.
L
L
Martín-Carbonero
Infectious Disease Department, Hospital Carlos III, Madrid, Spain.
V
V
Moreno
Infectious Disease Department, Hospital Carlos III, Madrid, Spain.
G
G
Ramírez-Olivenza
Infectious Disease Department, Hospital Carlos III, Madrid, Spain.
E
E
Valencia
D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D015497:HIV-1 / Q000187:drug effects*; D019694:Hepatitis B, Chronic / Q000150:complications; D019698:Hepatitis C, Chronic / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D009570:Nitriles; D011724:Pyridazines / Q000008:administration & dosage* / Q000009:adverse effects; D011743:Pyrimidines; D012189:Retrospective Studies; D013030:Spain; D016896:Treatment Outcome
D019380:Anti-HIV Agents; D009570:Nitriles; D011724:Pyridazines; D011743:Pyrimidines; C451734:etravirine
antiretroviral drugs; etravirine; toxicity