title: Efficacy and safety of switching to abacavir/lamivudine (ABC/3TC) plus rilpivirine (RPV) in virologically suppressed HIV-infected patients on HAART.
abstract: We analysed the efficacy and safety of switching from a regimen based on nonnucleoside reverse transcriptase inhibitors (NNRTI) or integrase inhibitors (INI) to ABC/3TC + RPV in virologically suppressed HIV-infected patients. This multicentre, retrospective study comprised asymptomatic HIV-infected patients who switched from 2 NRTI + NNRTI or 2 NRTI + INI to ABC/3TC + RPV between February 2013 and December 2013; all had undetectable HIV viral load prior to switching. Efficacy and safety, and changes in lipids and cardiovascular risk (CVR) were analysed at 48 weeks. Of 85 patients (74.1 % men, mean age 49.5 years), 83 (97.6 %) switched from a regimen based on NNRTI (EFV 74, RPV 5, ETV 2, NVP 2), and 45 (53 %) switched from TDF/FTC to ABC/3TC. The main reasons for switching were toxicity (58.8 %) and convenience (29.4 %). At 48 weeks, 78 (91.8 %) patients continued taking the same regimen; efficacy was 88 % by intention to treat, and 96 % by per protocol. Two patients were lost to follow-up and five ceased the new regimen (4 due to adverse effects and 1 virologic failure). Mean CD4 cell counts increased (744 vs. 885 cells/μL; p = 0.0001), and there were mean decreases in fasting total cholesterol (-15.9 mg/dL; p < 0.0001) and LDL-cholesterol (-11.0 mg/dL; p < 0.004), with no changes in HDL-cholesterol, triglycerides, total cholesterol:HDL-cholesterol ratio, and CVR. ABC/3TC + RPV is effective and safe in virologically-suppressed patients on antiretroviral therapy (ART). Forty-eight weeks after switching the lipid profile improved with decreases in total and LDL cholesterol.
authors.affiliation: Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain. rosariopalaci@gmail.com.|UGC Enfermedades Infecciosas, Hospital Clínico Universitario Virgen de la Victoria, 29010, Málaga, Spain. rosariopalaci@gmail.com.
authors.forename: R
authors.initials: R
authors.lastname: Palacios
authors.affiliation: Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.|UGC Enfermedades Infecciosas, Hospital Clínico Universitario Virgen de la Victoria, 29010, Málaga, Spain.
authors.forename: I A
authors.initials: IA
authors.lastname: Pérez-Hernández
authors.affiliation: Hospital Universitario de San Cecilio de Granada, Granada, Spain.
authors.forename: M A
authors.initials: MA
authors.lastname: Martínez
authors.affiliation: Hospital Regional Universitario Carlos Haya, Málaga, Spain.
authors.forename: M L
authors.initials: ML
authors.lastname: Mayorga
authors.affiliation: Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.
authors.forename: C M
authors.initials: CM
authors.lastname: González-Domenech
authors.affiliation: Hospital Universitario Ciudad de Jaén, Jaén, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Omar
authors.affiliation: Hospital Costa del Sol, Marbella, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Olalla
authors.affiliation: Hospital Universitario de Puerto Real, Cádiz, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Romero
authors.affiliation: Hospital Torrecárdenas, Almería, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Romero
authors.affiliation: Hospital de Poniente, Almería, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Pérez-Camacho
authors.affiliation: Hospital Universitario de San Cecilio de Granada, Granada, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Hernández-Quero
authors.affiliation: Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.|UGC Enfermedades Infecciosas, Hospital Clínico Universitario Virgen de la Victoria, 29010, Málaga, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Santos
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015224:Dideoxynucleosides / Q000009:adverse effects / Q000627:therapeutic use*; D004338:Drug Combinations; D057915:Drug Substitution; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000635:transmission / Q000821:virology*; D006801:Humans; D019259:Lamivudine / Q000009:adverse effects / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D000068696:Rilpivirine / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D019562:Viral Load; D000099227:Abacavir
chemical_list: D019380:Anti-HIV Agents; D015224:Dideoxynucleosides; D004338:Drug Combinations; D019259:Lamivudine; D008055:Lipids; D000068696:Rilpivirine; C492871:abacavir, lamivudine drug combination; D000099227:Abacavir