title: Efficacy of raltegravir-containing regimens in antiretroviral-naïve and -experienced individuals in routine clinical practice.
abstract: Raltegravir is one of the standard antiretroviral therapy (ART) options in treatment-experienced and -naïve patients. However, efficacy data from clinical practice are scarce. Therefore, the efficacy of raltegravir-containing ART in clinical practice was investigated retrospectively. In all, 295 treatment-naïve and -experienced patients were analysed using two different cut-offs for virological failure (200 or 50 copies/ml). The response at week 24 and onwards was evaluated as a 'time to loss of virological response' analysis and estimated as a survival function. Additionally, dual therapy regimens (raltegravir plus boosted protease inhibitor) were compared to standard combinations in experienced patients performing a snapshot analysis at weeks 24 and 48, as well as a time to loss of virological response analysis. A total of 86.2% of the 64 treatment-naïve patients maintained virological suppression using a cut-off of 200 copies/ml (c/ml), while 67.7% maintained virological suppression with a 50 copies/ml cut-off from week 24 until the end of observation. Among the 231 treatment-experienced patients, 84.8% maintained virological suppression from week 24 onwards using a cut-off of 200 copies/ml; and 71.0% using 50 copies/ml, respectively. In the subgroup snapshot analysis at week 24, 98.3% (86.7% using a cut-off of 50 copies/ml) and at week 48, 93.3% (80.0%) of patients responded to dual therapy. Patients who were receiving a standard background therapy responded in 88.3% (81.3%) at week 24 and in 86.0% (80.7%) at week 48. Differences were not significant. This study shows again the overall long-term efficacy of raltegravir-based ART and furthermore gives reference for a comparable efficacy of dual and standard nucleos(t)ide reverse transcriptase inhibitor-backbone regimens in experienced patients on raltegravir over a period of 48 weeks in a real-life cohort where patients with severe comorbidities were included.
authors.affiliation: HIV Center, Department of Infectious Diseases, University Hospital, Frankfurt, Germany Manuel.Jaeckle@kinderkliniken.de.
authors.forename: M
authors.initials: M
authors.lastname: Jaeckle
authors.affiliation: MainFachArzt, Specialist Practice for Infectious Diseases and Primary Care, Frankfurt, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Khaykin
authors.affiliation: HIV Center, Department of Infectious Diseases, University Hospital, Frankfurt, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Haberl
authors.affiliation: HIV Center, Department of Infectious Diseases, University Hospital, Frankfurt, Germany.
authors.forename: P
authors.initials: P
authors.lastname: De Leuw
authors.affiliation: HIV Center, Department of Infectious Diseases, University Hospital, Frankfurt, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Schüttfort
authors.affiliation: HIV Center, Department of Infectious Diseases, University Hospital, Frankfurt, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Stephan
authors.affiliation: HIV Center, Department of Infectious Diseases, University Hospital, Frankfurt, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Wolf
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000494:pharmacology / Q000627:therapeutic use*; D024882:Drug Resistance, Viral; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D019428:HIV Integrase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000068898:Raltegravir Potassium / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D019428:HIV Integrase Inhibitors; D000068898:Raltegravir Potassium
keywords: AIDS; Antiretroviral therapy; antiviral; human immunodeficiency virus; integrase inhibitor; raltegravir; treatment; viral disease