title: Initiation of rilpivirine, tenofovir and emtricitabine (RPV/TDF/FTC) regimen in 363 patients with virological vigilance assessment in 'real life'.
abstract: OBJECTIVE
  To study the single-tablet regimen (STR) combination rilpivirine/tenofovir/emtricitabine (RPV/TDF/FTC) as soon as it became available. We describe a 14 month follow-up in a real clinical setting with a focus on resistance to RPV/TDF/FTC and polymorphisms associated with these drugs.
  
  
  METHODS
  We estimated drug resistance at STR baseline by combining all available resistance tests, resulting in a cumulative virtual genotype. Physicians were advised of current or archived resistance mutations for the three drugs. Virological response was analysed according to resistance genotype at baseline.
  
  
  RESULTS
  Three hundred and sixty-three patients received RPV/TDF/FTC; 79% had received previous treatment and RPV/TDF/FTC was the result of a switch of one drug to rilpivirine in two-thirds of cases. The cumulative genotype showed 4% of rilpivirine resistance mutations at baseline and 16% of polymorphisms concerning non-nucleoside reverse transcriptase inhibitors (NNRTIs). With a median duration of STR of 8 months, 78% of patients with these polymorphisms were virologically suppressed compared with 96% with wild-type genotypes. Five genotypes were determined during the follow-up, revealing three rilpivirine resistance-associated mutations: E138Q/Y181I, M230L and K101P (potentially with a K101Q intermediate).
  
  
  CONCLUSIONS
  This observational study reflects routine clinical practice and the relevance of virological advice. It also confirms the efficacy of this STR (RPV/TDF/FTC) for naive and virologically suppressed pretreated patients with a low prevalence of virological failure and resistance if the cumulative baseline genotype is free of resistance to NNRTIs and/or polymorphisms associated with NNRTIs.
authors.affiliation: UPMC Univ Paris 06, Centre d'Immunologie et de Maladies Infectieuses (CIMI) UMRS CR7, Persistent Viral Infection (PVI) Team, Inserm U1135, 75013 Paris, France AP-HP, Groupe Hospitalier Paris Est, Virology Laboratory, Tenon Hospital, 75020 Paris, France corinne.amiel@tnn.aphp.fr.
authors.forename: Corinne
authors.initials: C
authors.lastname: Amiel
authors.affiliation: AP-HP, Groupe Hospitalier Paris Est, Virology Laboratory, Tenon Hospital, 75020 Paris, France.
authors.forename: Veronique
authors.initials: V
authors.lastname: Schneider
authors.affiliation: AP-HP Groupe Hospitalier Paris Est, Pharmacy, Tenon Hospital, 75020 Paris, France.
authors.forename: Sabine
authors.initials: S
authors.lastname: Guessant
authors.affiliation: AP-HP Groupe Hospitalier Paris Est, Infectious Disease Department, Tenon Hospital, 75020 Paris, France.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Hamidi
authors.affiliation: AP-HP, Groupe Hospitalier Paris Est, Virology Laboratory, Tenon Hospital, 75020 Paris, France.
authors.forename: Khadijah
authors.initials: K
authors.lastname: Kherallah
authors.affiliation: AP-HP Groupe Hospitalier Paris Est, Infectious Disease Department, Tenon Hospital, 75020 Paris, France.
authors.forename: Marie-Gisele
authors.initials: MG
authors.lastname: Lebrette
authors.affiliation: AP-HP Groupe Hospitalier Paris Est, Infectious Disease Department, Tenon Hospital, 75020 Paris, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Chas
authors.affiliation: AP-HP, Groupe Hospitalier Paris Est, Virology Laboratory, Tenon Hospital, 75020 Paris, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Lependeven
authors.affiliation: UPMC Univ Paris 06, Centre d'Immunologie et de Maladies Infectieuses (CIMI) UMRS CR7, Persistent Viral Infection (PVI) Team, Inserm U1135, 75013 Paris, France AP-HP Groupe Hospitalier Paris Est, Infectious Disease Department, Tenon Hospital, 75020 Paris, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Pialoux
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D024882:Drug Resistance, Viral; D000068679:Emtricitabine; D005838:Genotype; D006678:HIV / Q000187:drug effects* / Q000302:isolation & purification; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D008826:Microbial Sensitivity Tests; D009570:Nitriles / Q000627:therapeutic use*; D063065:Organophosphonates / Q000627:therapeutic use*; D011743:Pyrimidines / Q000627:therapeutic use*; D000068696:Rilpivirine; D000068698:Tenofovir
chemical_list: D019380:Anti-HIV Agents; D009570:Nitriles; D063065:Organophosphonates; D011743:Pyrimidines; D003841:Deoxycytidine; D000068698:Tenofovir; D000068696:Rilpivirine; D000068679:Emtricitabine; D000225:Adenine
keywords: HIV-1; STR; cumulative genotype; resistance; vigilance