title: Switch as maintenance to elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate: week 48 results in a clinical cohort.
abstract: To assess, in a clinical cohort, the efficacy of switching current ART in virologically suppressed patients to elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate as a single-tablet regimen (STR) using the PCR signal of the plasma viral load (pVL) assay and determination of plasma drug concentration ( C 24 ).
  
  
  
  This was an observational single-centre study enrolling antiretroviral-treated patients with pVL <50 copies/mL initiating elvitegravir-based STR. PCRneg was defined as an undetected PCR signal.
  
  
  
  One hundred and fifty-one patients were enrolled. At STR baseline, the median time since first ART and time of virological suppression were 5 years (IQR 3-9) and 24 months (IQR 9-44), respectively. By week (W) 48, 26 (17%) of the patients had discontinued STR due to adverse events. The proportion of patients maintaining pVL <50 copies/mL on treatment was 98%, 96%, 93% and 97% at W12, W24, W36 and W48, respectively. Five patients (3.3%) experienced a virological failure and emergence of resistance was observed in two of them with the selection of M184V and N155H mutations. At baseline, W12, W24, W36 and W48, 70%, 57%, 72%, 61% and 74% of the patients with pVL <20 copies/mL had a PCRneg, respectively. The median elvitegravir plasma C 24 value was 648 ng/mL (IQR 348-989; n  =   237), with 84% of elvitegravir C 24 values >45 ng/mL, the protein-adjusted IC 95 .
  
  
  
  In this clinical cohort of virologically suppressed patients switching to STR, most subjects had adequate elvitegravir C 24 values with a high proportion maintaining virological suppression with no residual viraemia until W48.
authors.affiliation: IAME, UMR 1137, Univ. Paris Diderot, Sorbonne Paris Cité, Paris F-75018, France.|AP-HP, Hôpital Bichat-Claude Bernard, Laboratoire de Virologie, Paris F-75018, France.
authors.forename: Marine
authors.initials: M
authors.lastname: Perrier
authors.affiliation: IAME, UMR 1137, Univ. Paris Diderot, Sorbonne Paris Cité, Paris F-75018, France.|AP-HP, Hôpital Bichat-Claude Bernard, Laboratoire de Virologie, Paris F-75018, France.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Charpentier
authors.affiliation: IAME, UMR 1137, Univ. Paris Diderot, Sorbonne Paris Cité, Paris F-75018, France.|IAME, UMR 1137, INSERM, Paris F-75018, France.|AP-HP, Hôpital Bichat-Claude Bernard, Laboratoire de Pharmacologie, Paris F-75018, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Peytavin
authors.affiliation: IAME, UMR 1137, Univ. Paris Diderot, Sorbonne Paris Cité, Paris F-75018, France.|IAME, UMR 1137, INSERM, Paris F-75018, France.|AP-HP, Hôpital Bichat-Claude Bernard, Laboratoire de Pharmacologie, Paris F-75018, France.
authors.forename: Minh
authors.initials: M
authors.lastname: Lê
authors.affiliation: AP-HP, Hôpital Bichat-Claude Bernard, Laboratoire de Pharmacologie, Paris F-75018, France.
authors.forename: Louis
authors.initials: L
authors.lastname: Blondel
authors.affiliation: IAME, UMR 1137, Univ. Paris Diderot, Sorbonne Paris Cité, Paris F-75018, France.|AP-HP, Hôpital Bichat-Claude Bernard, Laboratoire de Virologie, Paris F-75018, France.
authors.forename: Benoit
authors.initials: B
authors.lastname: Visseaux
authors.affiliation: IAME, UMR 1137, Univ. Paris Diderot, Sorbonne Paris Cité, Paris F-75018, France.|IAME, UMR 1137, INSERM, Paris F-75018, France.|AP-HP, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales, Paris F-75018, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Joly
authors.affiliation: AP-HP, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales, Paris F-75018, France.
authors.forename: Adriana
authors.initials: A
authors.lastname: Pinto
authors.affiliation: IAME, UMR 1137, Univ. Paris Diderot, Sorbonne Paris Cité, Paris F-75018, France.|IAME, UMR 1137, INSERM, Paris F-75018, France.|AP-HP, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales, Paris F-75018, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Matheron
authors.affiliation: IAME, UMR 1137, Univ. Paris Diderot, Sorbonne Paris Cité, Paris F-75018, France.|IAME, UMR 1137, INSERM, Paris F-75018, France.|AP-HP, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales, Paris F-75018, France.
authors.forename: Yazdan
authors.initials: Y
authors.lastname: Yazdanpanah
authors.affiliation: IAME, UMR 1137, Univ. Paris Diderot, Sorbonne Paris Cité, Paris F-75018, France.|AP-HP, Hôpital Bichat-Claude Bernard, Laboratoire de Virologie, Paris F-75018, France.
authors.forename: Diane
authors.initials: D
authors.lastname: Descamps
authors.affiliation: IAME, UMR 1137, Univ. Paris Diderot, Sorbonne Paris Cité, Paris F-75018, France.|IAME, UMR 1137, INSERM, Paris F-75018, France.|AP-HP, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales, Paris F-75018, France.
authors.forename: Roland
authors.initials: R
authors.lastname: Landman
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D000069547:Cobicistat / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use; D015331:Cohort Studies; D000068679:Emtricitabine / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy; D015497:HIV-1 / Q000187:drug effects; D060046:Maintenance Chemotherapy; D016133:Polymerase Chain Reaction; D015363:Quinolones / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use; D012367:RNA, Viral / Q000097:blood; D013607:Tablets; D000068698:Tenofovir / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use; D019562:Viral Load; D014766:Viremia / Q000188:drug therapy
chemical_list: D019380:Anti-HIV Agents; D000069547:Cobicistat; C509700:elvitegravir; D000068679:Emtricitabine; D015363:Quinolones; D012367:RNA, Viral; D013607:Tablets; D000068698:Tenofovir