In China,approximately 13% of people living with human immunodeficiency virus(HIV)(PLWH)are receiving lopinavir/ritonavir(LPV/r)-based regimens.These PLWH typically have a history of either treatment failure or intole...In China,approximately 13% of people living with human immunodeficiency virus(HIV)(PLWH)are receiving lopinavir/ritonavir(LPV/r)-based regimens.These PLWH typically have a history of either treatment failure or intolerance to first-line efavirenz-based regimens.Given the considerable pill burden and adverse effects associated with LPV/r,treatment optimization is important for this population.This multicenter retrospective study aimed to evaluate the efficacy and safety of switching from LPV/r-based regimens to the single-tablet regimen of bictegravir/emtricitabine/tenofovir alafenamide(BIC/FTC/TAF).Virological suppression rates(HIV-RNA<40 copies/mL)were primarily compared between the 48-week periods before and after switching to BIC/FTC/TAF.CD4 counts and metabolic data were also assessed.A total of 461 PLWH were recruited between January 2021 and December 2023,with 92.2% being male,a median age of 38 years,and a median antiretroviral therapy duration of 8 years.Prior to initiating LPV/r,23.0%(106/461)had documented virological failure.During LPV/r treatment,18.9%(20/106)of these individuals experienced viral rebound.Among all participants,the overall virological suppression rates significantly increased from 94.6%(pre-switch)to 98.6%(post-switch)(P<0.001).Notably,among participants with prior virological failure,suppression rates improved significantly from 81.1%to 97.2%(P<0.001),whereas no significant difference was observed in those without such history(from 98.6% to 99.2%,P=0.764).The median triglyceride level decreased from 2.4 mmol/L to 1.8 mmol/L(P<0.001),while no difference in CD4 counts was observed.These findings demonstrate that BIC/FTC/TAF is an effective and metabolically favorable treatment option for PLWH switching from LPV/r based regimens,regardless of whether they have a prior history of virological failure.展开更多
基金supported by the Capital's Funds for Health Improvement and Research(CFH2024-2-2175).
文摘In China,approximately 13% of people living with human immunodeficiency virus(HIV)(PLWH)are receiving lopinavir/ritonavir(LPV/r)-based regimens.These PLWH typically have a history of either treatment failure or intolerance to first-line efavirenz-based regimens.Given the considerable pill burden and adverse effects associated with LPV/r,treatment optimization is important for this population.This multicenter retrospective study aimed to evaluate the efficacy and safety of switching from LPV/r-based regimens to the single-tablet regimen of bictegravir/emtricitabine/tenofovir alafenamide(BIC/FTC/TAF).Virological suppression rates(HIV-RNA<40 copies/mL)were primarily compared between the 48-week periods before and after switching to BIC/FTC/TAF.CD4 counts and metabolic data were also assessed.A total of 461 PLWH were recruited between January 2021 and December 2023,with 92.2% being male,a median age of 38 years,and a median antiretroviral therapy duration of 8 years.Prior to initiating LPV/r,23.0%(106/461)had documented virological failure.During LPV/r treatment,18.9%(20/106)of these individuals experienced viral rebound.Among all participants,the overall virological suppression rates significantly increased from 94.6%(pre-switch)to 98.6%(post-switch)(P<0.001).Notably,among participants with prior virological failure,suppression rates improved significantly from 81.1%to 97.2%(P<0.001),whereas no significant difference was observed in those without such history(from 98.6% to 99.2%,P=0.764).The median triglyceride level decreased from 2.4 mmol/L to 1.8 mmol/L(P<0.001),while no difference in CD4 counts was observed.These findings demonstrate that BIC/FTC/TAF is an effective and metabolically favorable treatment option for PLWH switching from LPV/r based regimens,regardless of whether they have a prior history of virological failure.
