Complera (emtricitabine/rilpivirine/tenofovir) / Gilead, J&J - LARVOL DELTA

Adherence and Forgiveness of Two Modern ART Regimens: Lamivudine/Dolutegravir and Emtricitabine/Tenofovir Alafenamide/Rilpivirine. (PubMed, J Acquir Immune Defic Syndr) - "In this study, we found a similar and high level of forgiveness with the INSTI-based 2-drug regimen 3TC/DTG and the NNRTI-based 3-drug regimen FTC/TAF/RPV."

Journal • Observational data • Retrospective data • Human Immunodeficiency Virus • Infectious Disease • CD4

Weight and metabolic changes with long-acting cabotegravir and rilpivirine or bictegravir/emtricitabine/tenofovir alafenamide. (PubMed, J Acquir Immune Defic Syndr) - "Standardized changes in weight, BMI, and body composition were minor and similar between participant switching to CAB+RPV LA Q2M or continuing BIC/FTC/TAF, with no clinically relevant changes in metabolic syndrome or insulin resistance."

Journal • Aesthetic Medicine • Human Immunodeficiency Virus • Infectious Disease • Metabolic Disorders

Metabolic Outcomes of Changing From Rilpivirine/Tenofovir Disoproxil Fumarate/Emtricitabine to Rilpivirine/Tenofovir Alafenamide/Emtricitabine: A Longitudinal Study. (PubMed, Health Sci Rep) - "A gradually higher prevalence of metabolic syndrome among PLWH occurred with changes from RPV/TDF/FTC to RPV/TAF/FTC but plateaued beyond 2 years. However, fewer drugs for dyslipidemia, diabetes, and hypertension were prescribed within the first year after changing cART."

Journal • Observational data • Cardiovascular • Diabetes • Dyslipidemia • Human Immunodeficiency Virus • Hypertension • Infectious Disease • Metabolic Disorders

Discontinuation rates of doravirine/lamivudine/tenofovir‐DF due to neuropsychiatric adverse effects (HIV-Glasgow 2024) - "Due to high costs, NHS England antiretroviral commissioning policies [2] encouraged to consider switching away from rilpivirine/emtricitabine/tenofovir-DF (RPV/F/TDF) in people living with HIV offering generic formulation switches. Rates of NPAE leading to discontinuation of DOR/L/TDF when switching from RPV/F/TDF in this small cohort are higher than described in large randomized studies and ongoing vigilance is justified. Importantly, all patients were involved in their ART decision-making and regular screening of adverse effects is required."

Adverse events • Human Immunodeficiency Virus • Infectious Disease • Insomnia • Pain • Psychiatry • Sleep Disorder

Complexities of Managing Chronic Hepatitis B in HIV: A Case of Acute Liver Injury Post-Medication Change (ACG 2024) - "On further history-taking, she reported a recent change in her HIV medication regimen from Efavirenz/Emtricitabine/Tenofovir to Dolutegravir/Rilpivirine in view of her worsening kidney function...Treatment with Entecavir and Lamivudine was initiated...As in our case, pegylated interferon or nucleos(t)ide analogues can be given to curb liver disease progression in affected individuals. Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024."

Clinical • Hepatitis B • Hepatitis C • Hepatology • Human Immunodeficiency Virus • Infectious Disease • Inflammation • Liver Failure • Pain • CD4

HIV-1 resistance and virological failure to treatment with the integrase inhibitors bictegravir, cabotegravir, and dolutegravir: a systematic literature review. (PubMed, AIDS Rev) - "We describe and analyze resistance-associated mutations (RM) and virological failures (VF) on antiretroviral therapy using the latest approved integrase inhibitors (INIs) dolutegravir (DTG), bictegravir (BIC), and cabotegravir (CAB), together with their companion drugs in fixed-dose formulations: BIC/emtricitabine/tenofovir; CAB/rilpivirine; DTG/abacavir/lamivudine; DTG/emtricitabine/tenofovir; and DTG/lamivudine. In conclusion, RM rates in the studies reviewed were generally low using the latest INIs. This review identified BIC as the INI with the lowest number of observed VF and lack of RM."

Journal • Review • Human Immunodeficiency Virus • Infectious Disease

De-simplifying antiretroviral therapy from a single-tablet to a two-tablet regimen: Acceptance, patient-reported outcomes, and cost savings in a multicentre study. (PubMed, HIV Med) - "De-simplification from an STR to a TTR within the Dutch healthcare setting has been demonstrated as feasible, leads to significant cost reductions and should be discussed with every eligible person with HIV in the Netherlands."

HEOR • Journal • Patient reported outcomes • Human Immunodeficiency Virus • Infectious Disease

Impact of switching to injectables cabotegravir and rilpivirine on sleep disturbances in a cohort of people living with HIV. (PubMed, HIV Res Clin Pract) - "Baseline antiretroviral regimens were mostly: tenofovir alafenamide/emtricitabine/rilpivirine (39.1%) and dolutegravir/lamivudine (32.6%). Despite integrase inhibitor have been associated with SD, we did not observed a negative impact on sleep quality after the switch to ICAB/RPV. More studies and with larger number of people are necessary to confirm our results."

Journal • CNS Disorders • Human Immunodeficiency Virus • Infectious Disease • Insomnia • Sleep Disorder • CD4

Underlying Neural Mechanisms of Cognitive Improvement in Fronto-striatal Response Inhibition in People Living with HIV Switching Off Efavirenz: A Randomized Controlled BOLD fMRI Trial. (PubMed, Infect Dis Ther) - P4 | "Potential neural mechanisms underlying cognitive improvement after discontinuing EFV in PLWH were found in subcortical functioning, with our findings suggesting that EFV's effect on attention and processing speed is, at least partially, mediated by reactive inhibition."

Journal • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Developmental Disorders • Human Immunodeficiency Virus • Infectious Disease

Negative impact of a health insurer-mandated de-simplification from a single-tablet regimen to a two-tablet regimen. (PubMed, AIDS) - "A mandatory switch from an STR to a TTR in people with HIV proved unsuccessful, marked by low acceptance, and increased costs after one year. This underscores the necessity of incorporating patient and prescriber involvement in changing medication policies."

Journal • Human Immunodeficiency Virus • Infectious Disease

Bone turnover change after randomised switch from tenofovir disoproxil to tenofovir alafenamide fumarate in men with HIV. (PubMed, AIDS) - "Contrary to our hypothesis, lumbar spine and total hip regional bone formation (SUVmean) and BMD did not differ postswitch to TAF. However, improved LS-BMD and CTX echo other TAF-switch studies. The lack of difference in SUVmean may be due to inadequate power."

Journal • Human Immunodeficiency Virus • Infectious Disease • Osteoporosis

Acute IRIS-Related HBV Flare Unmasked After Antiretroviral Therapy Initiation in a HIV/HBV Coinfected Patient (ACG 2023) - "ART was continued but switched to Rilpivirine/Tenofovir Alafenamide/Emtricitabine, considering the hypothetical risk of hepatotoxicity from Bictegravir/Emtricitabine/Tenofovir Alafenamide. Management usually involves continuation of ART targeting both viruses as discontinuation could worsen the flare and increase the risk of drug resistance with steroids reserve for severe cases only. Figure: Liver biopsy showing acute inflammation with lymphocyte predominance (Hematoxylin & Eosin stain)"

Clinical • Cholestasis • Hepatitis B • Hepatitis C • Hepatology • Human Immunodeficiency Virus • Immunology • Infectious Disease • Inflammation • Musculoskeletal Pain • CD4

Acute Immune Reconstitution Inflammatory Syndrome-HBV Flare in an HIV/HBV Coinfected Patient After Antiretroviral Therapy Initiation: Case Report and Literature Review. (PubMed, Am J Case Rep) - "He came to establish care and was started on bictegravir/emtricitabine/tenofovir alafenamide (BIC/F/TAF)...ART was switched to rilpivirine/emtricitabine/tenofovir alafenamide (RPV/FTC/TAF), considering the hypothetical risk of hepatotoxicity from BIC/F/TAF...Liver biopsy is indicated for definitive diagnosis. ART directed against both viruses should be continued."

Journal • Review • Hepatitis B • Hepatitis C • Hepatology • Human Immunodeficiency Virus • Infectious Disease • Inflammation • Musculoskeletal Pain

Bictegravir/Emtricitabine/Tenofovir Alafenamide Plus Doravirine in Highly Treatment-Experienced Men With Multidrug-Resistant HIV. (PubMed, AIDS) - "Switching from RPV/FTC/TAF plus DTG to BIC/FTC/TAF plus DOR was well tolerated and efficacious in HTE men aged ≥45 years with HIV."

Journal • Human Immunodeficiency Virus • Infectious Disease

The effect of efavirenz on reward processing in asymptomatic people living with HIV: a randomized controlled trial. (PubMed, AIDS Res Hum Retroviruses) - "In this multicenter randomized controlled trial, asymptomatic adult participants stable on emtricitabine/tenofovirdisoproxil/efavirenz (FTC/TDF/EFV) were randomly assigned in a 2:1 ratio to switch to emtricitabine/tenofovirdisoproxil/rilpivirine (FTC/TDF/RPV) (n=30) or continue taking FTC/TDF/EFV (n=13). It is therefore likely that EFV does not affect motivational control. Further research is needed to determine whether EFV affects motivational control in HIV populations with different characteristics."

Journal • Human Immunodeficiency Virus • Infectious Disease

CTN289: HIV Drug Switch Followed by HCV Therapy in HIV-HCV Co-Infection (clinicaltrials.gov) - P3 | N=25 | Completed | Sponsor: Ottawa Hospital Research Institute | Unknown status ➔ Completed

Trial completion • Hepatitis C • Hepatology • Human Immunodeficiency Virus • Immunology • Infectious Disease • Inflammation

The analysis of the availability of fixed-dose combinations in antiretroviral therapy for HIV infection in the Russian Federation (PubMed, Ter Arkh) - "The inclusion of new effective and economical FDCs the whole scheme in one tablet once-daily in VEDL, expands the possibilities of simplify and effective first-line therapy for special groups of HIV-infected patients, as well as reduce the financial burden on the Program of State Guarantees budget and increases treatment coverage. All of this corresponds to the goals of the State Strategy to Combat the Spread of HIV in Russian Federation."

Journal • Human Immunodeficiency Virus • Immunology • Infectious Disease

"I’ve noticed big weight gain on Eviplera - how does this relate? Any advice? Thanks" (@Perry44359880)

Estimated changes in price discounts for tenofovir-inclusive HIV treatments following introduction of tenofovir alafenamide. (PubMed, AIDS) - "We estimated list and net prices for tenofovir disoproxil fumarate (TDF) products Truvada, Complera, and Stribild, and their tenofovir alafenamide (TAF) versions Descovy, Odefsey, and Genvoya. This strategy encouraged patients switching from Truvada to Descovy before the availability of generic Truvada. Conversely, Gilead offered lower discounts for Odefsey and Genvoya, which resulted into higher net prices compared to Complera and Stribild."

Journal • Human Immunodeficiency Virus • Infectious Disease

Observational cohort study of rilpivirine (RPV) utilization in Europe. (PubMed, AIDS Res Ther) - "Our estimates of VF > 50 copies/mL and resistance in participants treated with RPV were similar to those reported by other studies. RPV safety profile was favourable with less frequent discontinuation due to toxicity than EFV (especially for CNS)."

Journal • Observational data • Human Immunodeficiency Virus • Infectious Disease • CD4

High Prevalence of Doravirine Resistance in HIV-1-Infected Patients with Virological Failure to an NNRTI-Based Single-Tablet Regimen. (PubMed, Infect Drug Resist) - "Seventy-four patients failed treatment with TDF/FTC/EFV (Atripla), 30 with TDF/FTC/RPV (Complera) and 3 with TAF/FTC/RPV (Odefsey). Our findings showed a high rate of doravirine cross-resistance in patients with NNRTI-based STR treatment failure. Doravirine should be used cautiously as a salvage regimen in patients who fail NNRTI treatment."

Journal • Human Immunodeficiency Virus • Infectious Disease

Safety and efficacy of switching to BIC/FTC/TAF plus DOR in HIV-infected patients with multiclass-resistant virus (AIDS 2022) - "With approval of the single-tablet regimen bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) and the nonnucleoside reverse transcriptase inhibitor (NNRTI) doravirine (DOR), switching patients with multiclass-resistant virus to BIC/FTC/TAF plus DOR may be beneficial as both BIC/FTC/TAF and DOR have a high barrier to resistance, no food restrictions, and low potential for DDIs and AEs. This study evaluated the safety and efficacy of switching from rilpivirine/emtricitabine/tenofovir alafenamide (RPV/FTC/TAF) plus dolutegravir (DTG), to BIC/FTC/TAF plus DOR in multiclass-resistant patients... Switching from RPV/FTC/TAF plus DTG to BIC/FTC/TAF plus DOR in HIV-infected males with multiclass-resistant virus was well tolerated and efficacious with an advantageous AE profile and no food restrictions."

Clinical • Human Immunodeficiency Virus • Infectious Disease • CD4

Temporal Trends and Geographic Variability in the Prescription of Antiretroviral Treatments in People Living with HIV in Spain, 2004-2020. (PubMed, J Clin Med) - "Robust real-world data on ART use in PLWHIV over more than 15 years show historical trends in prescriptions with an unprecedented visualization of the contemporary treatment patterns."

Journal • Human Immunodeficiency Virus • Immunology • Infectious Disease

"I use Complera and Odefsey sometimes to avoid INSTIs if I am super concerned about it. Personally I think the jury is still out on TAF and weight gain." (@Weavofloxacin)

Use of generic antiretroviral drugs and single-tablet regimen de-simplification for the treatment of HIV infection in Spain. (PubMed, AIDS Res Hum Retroviruses) - "The median times between the date of effective marketing of generic TDF/FTC and the date of de-simplification of EFV/TDF/FTC and RPV/TDF/FTC were 723 (IQR: 369-1119) and 234 (IQR: 142-264) days, respectively; this time was 155 (IQR: 28 - 287) days for de-simplification of DTG/ABC/3TC. In conclusion, in spite of the widespread use of generic ARVs, STRs de-simplification was only undertaken in less than 20% of the hospitals. There was wide variability in the timing of the introduction of each generic ARVs after they were available in the market."

Journal • Human Immunodeficiency Virus • Infectious Disease