title: Pre-existent NRTI and NNRTI resistance impacts on maintenance of virological suppression in HIV-1-infected patients who switch to a tenofovir/emtricitabine/rilpivirine single-tablet regimen.
abstract: To evaluate the maintenance of virological suppression (VS) in antiretroviral-treated HIV-1-suppressed patients switching to a tenofovir/emtricitabine/rilpivirine (TDF/FTC/RPV) single-tablet regimen, by considering pre-existent resistance (pRes).
  
  
  
  pRes was evaluated according to resistance on all previous plasma genotypic resistance tests. Probability and predictors of virological rebound (VR) were evaluated.
  
  
  
  Three hundred and nine patients were analysed; 5.8% of them showed resistance to both NRTIs and NNRTIs, while 12.6% showed resistance to only one of these drug classes. By 72 weeks, the probability of VR was 11.3%. A higher probability of VR was found in the following groups: (i) patients with NRTI + NNRTI pRes compared with those harbouring NRTI or NNRTI pRes and with those without reverse transcriptase inhibitor pRes (39.2% versus 11.5% versus 9.4%, P  <   0.0001); (ii) patients with a virus with full/intermediate resistance to both tenofovir/emtricitabine and rilpivirine compared with those having a virus with full/intermediate resistance to tenofovir/emtricitabine or rilpivirine and those having a virus fully susceptible to TDF/FTC/RPV (36.4% versus 17.8% versus 9.7%, P  <   0.001); and (iii) patients with pre-therapy viraemia >500 000 copies/mL compared with those with lower viraemia levels (>500 000: 16.0%; 100 000-500 000: 9.3%; <100 000 copies/mL: 4.8%, P  =   0.009). pRes and pre-therapy viraemia >500 000 copies/mL were independent predictors of VR by multivariable Cox regression.
  
  
  
  TDF/FTC/RPV as a treatment simplification strategy shows a very high rate of VS maintenance. The presence of pRes to both NRTIs and NNRTIs and a pre-therapy viraemia >500 000 copies/mL are associated with an increased risk of VR, highlighting the need for an accurate selection of patients before simplification.
authors.affiliation: Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Armenia
authors.affiliation: Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Di Carlo
authors.affiliation: Division of Infectious Diseases, University of Turin, Turin, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Calcagno
authors.affiliation: Division of Infectious Diseases, University of Turin, Turin, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Vendemiati
authors.affiliation: Antiretroviral Drug Monitoring Laboratory, National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Forbici
authors.affiliation: Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Bertoli
authors.affiliation: Antiretroviral Drug Monitoring Laboratory, National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Berno
authors.affiliation: Antiretroviral Drug Monitoring Laboratory, National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Carta
authors.affiliation: Antiretroviral Drug Monitoring Laboratory, National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Continenza
authors.affiliation: Antiretroviral Drug Monitoring Laboratory, National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Fedele
authors.affiliation: Infectious Diseases Division, National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Bellagamba
authors.affiliation: Infectious Diseases Division, National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Cicalini
authors.affiliation: Infectious Diseases Division, National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Ammassari
authors.affiliation: Infectious Diseases Division, National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Libertone
authors.affiliation: Infectious Diseases Division, National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Zaccarelli
authors.affiliation: Division of Infectious Diseases, University of Turin, Turin, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Ghisetti
authors.affiliation: Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Andreoni
authors.affiliation: Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Ceccherini-Silberstein
authors.affiliation: Division of Infectious Diseases, University of Turin, Turin, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Bonora
authors.affiliation: Division of Infectious Diseases, University of Turin, Turin, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Di Perri
authors.affiliation: Infectious Diseases Division, National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Antinori
authors.affiliation: Antiretroviral Drug Monitoring Laboratory, National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy.
authors.forename: C F
authors.initials: CF
authors.lastname: Perno
authors.affiliation: Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy.
authors.forename: M M
authors.initials: MM
authors.lastname: Santoro
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003841:Deoxycytidine / Q000627:therapeutic use; D004338:Drug Combinations; D000068679:Emtricitabine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D015497:HIV-1 / Q000187:drug effects / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D000068696:Rilpivirine / Q000008:administration & dosage / Q000627:therapeutic use*; D013607:Tablets; D000068698:Tenofovir / Q000008:administration & dosage / Q000627:therapeutic use*; D019562:Viral Load / Q000187:drug effects*
chemical_list: D019380:Anti-HIV Agents; D004338:Drug Combinations; D012367:RNA, Viral; D018894:Reverse Transcriptase Inhibitors; D013607:Tablets; D003841:Deoxycytidine; D000068698:Tenofovir; D000068696:Rilpivirine; D000068679:Emtricitabine