Format

Send to

Choose Destination
J Antimicrob Chemother. 2020 Jan 1;75(1):208-214. doi: 10.1093/jac/dkz399.

Factors associated with the number of drugs in darunavir/cobicistat regimens.

Author information

1
Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain.
2
Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
3
Hospital del Mar, Barcelona, Spain.
4
Hospital Alvaro Cunqueiro, Vigo, Spain.
5
Hospital Universitario Principe de Asturias, Alcala de Henares, Spain.
6
Hospital Universitario La Princesa, Madrid, Spain.
7
Hospital Universitario La Paz, Madrid, Spain.
8
Hospital Virgen de Valme, Sevilla, Spain.
9
Hospital Universitario Virgen de la Victoria, Malaga, Spain.
10
Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
11
Hospital Universitario y Politecnico La Fe, Valencia, Spain.
12
Hospital General Universitario de Alicante, Alicante, Spain.
13
Hospital Sont Llatzer, Palma de Mallorca, Spain.
14
Hospital Universitario de Guadalajara, Guadalajara, Spain.
15
Hospital Universitario Ramón y Cajal, Madrid, Spain.
16
Instituto de Salud Carlos III, Madrid, Spain.

Abstract

BACKGROUND:

Darunavir/cobicistat can be used as mono, dual, triple or more than triple therapy.

OBJECTIVES:

To assess factors associated with the number of drugs in darunavir/cobicistat regimens.

METHODS:

A nationwide retrospective cohort study of consecutive HIV-infected patients initiating darunavir/cobicistat in Spain from July 2015 to May 2017. Baseline characteristics, efficacy and safety at 48 weeks were compared according to the number of drugs used.

RESULTS:

There were 761 patients (75% men, 98% were antiretroviral-experienced, 32% had prior AIDS, 84% had HIV RNA <50 copies/mL and 88% had ≥200 CD4 cells/mm3) who initiated darunavir/cobicistat as mono (n=308, 40%), dual (n=173, 23%), triple (n=253, 33%) or four-drug (n=27, 4%) therapy. Relative to monotherapy, triple therapy was more common in men aged <50 years, with prior AIDS and darunavir plus ritonavir use, and with CD4 cells <200/mm3 and with detectable viral load at initiation of darunavir/cobicistat; dual therapy was more common with previous intravenous drug use, detectable viral load at initiation of darunavir/cobicistat and no prior darunavir plus ritonavir; and four-drug therapy was more common with prior AIDS and detectable viral load at initiation of darunavir/cobicistat. Monotherapy and dual therapy showed a trend to better virological responses than triple therapy. CD4 responses and adverse effects did not differ among regimens.

DISCUSSION:

Darunavir/cobicistat use in Spain has been tailored according to clinical characteristics of HIV-infected patients. Monotherapy and dual therapy have been common and preferentially addressed to older patients with a better HIV status, suggesting that health issues other than HIV infection may have been strong determinants of its prescription.

PMID:
31586414
DOI:
10.1093/jac/dkz399

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center