Raltegravir Plus Abacavir/Lamivudine: Effective HIV-1 Switch Therapy in Virologically Suppressed Patients

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Raltegravir combined with abacavir/lamivudine is a safe and well tolerated switching strategy for patients with stable HIV-1 infection
Raltegravir combined with abacavir/lamivudine is a safe and well tolerated switching strategy for patients with stable HIV-1 infection

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.

Reference

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.

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