Impact of elvitegravir/cobicistat/tenofovir/emtricitabine failure on treatment options

• Published in: Antiviral therapy Vol. 19; p. A143
• Main Authors: Mackie, N E, Webster, D, Geretti, A M
• Format: Journal Article
• Language: English
• Published: 01.01.2014
• Subjects: Human immunodeficiency virus 1
• ISSN: 1359-6535

Virological failure of first-line ART is now uncommon. For patients who experience failure however, defining the impact of the associated drug resistance is required to guide long-term management. The study aim was to analyse treatment-emergent resistance within the two registration trials for elvitegravir/cobicistat/tenofovir/emtricitabine in order to define the impact on predicted drug activity and treatment options. In STUDIES 102 & 103 subjects with confirmed HIV-1 RNA less than 400 copies/ml underwent resistance testing. The genotypic mutation profiles observed within the EVG/c/TDF/FTC arms were assigned a genotypic resistance score (GRS) defined by resistance level and number of drugs affected. Using the Stanford Interpretation Algorithm, resistance levels were 0 for susceptible/potential resistance, 0.5 for low/intermediate resistance, and 1 for high-level resistance. Patients receiving first-line EVG/c/TDF/FTC had a low overall risk of virological failure and resistance. Based upon the mutation profiles observed, preferred second-line treatment options were similar to those recommended after failure of first-line NNRTIbased ART.