Raltegravir (RAL) combined with abacavir/lamivudine (ABC/3TC) is effective, safe, well tolerated, and is an inexpensive switching strategy for people with stable HIV-1 infection, according to new findings published in PLoS One.
Long-term treatment with combination antiretroviral therapy is associated with toxicity, and patient issues with tolerability is one of the primary reasons for switching therapy. RAL has a favorable profile, but data on its combination with ABC/3TC are limited.
The authors evaluated this combination as a switching strategy in a multicenter, noncontrolled, retrospective study that included 467 people with HIV-1 infection and virologic suppression who had switched to RAL+ABC/3TC.
The primary end point of the study was the percentage of patients able to maintain virologic suppression (HIV-1 RNA <50 copies/mL) after 48 weeks.
The median CD4+ count at baseline was 580 cells/μL (interquartile range, 409), and primary reason for changing treatment regimens was drug toxicity/tolerability (197 patients, 42.2%), followed by physician’s criteria (133 patients, 28.5%), and other, unknown reasons (123 patients, 26.3%).
At week 48, the primary end point was achieved by 371/380 patients (RNA remained at<50 copies/mL, 97.6% [95% CI, 96.4-99.0]) after censoring nonvirologic failures.
Virologic failure occurred in 1.9% of patients and the proportion of patients at risk for treatment failure was 20.5% (96/467 [95%CI, 16.9-24.2]). The rate of adverse events was low, with 64 patients (13.7%) experiencing 73 events.
“Our findings revealed a high percentage of treatment success, thus indicating that RAL+ ABC/3TC has a high virological suppression rate that is in the same range as other switching therapies,” write the authors.
By Roxanne Nelson
Troya J, Montejano R, Ryan P, et al. Raltegravir plus abacavir/lamivudine in virologically suppressed HIV-1-infected patients: 48-week results of the KIRAL study. PLoS One. 2018 Jun 14;13(6):e0198768.