Biagi M, Badowski M E, Chiampas T, Young J, Patel M, Vaughn P
1 Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA.
2 Section of Infectious Diseases, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA.
Int J STD AIDS. 2017 Jul;28(8):766-772. doi: 10.1177/0956462416666440. Epub 2016 Sep 1.
We report the use of elvitegravir 150 mg/cobicistat 150 mg/tenofovir disoproxil fumarate 300 mg/emtricitabine 200 mg (EVG/COBI/TDF/FTC) once daily, in addition to once-daily atazanavir (ATV) 300 mg, in treatment-experienced patients with human immunodeficiency virus (HIV). Due to limited data available on the co-administration of these agents, our objective was to evaluate and monitor safety and efficacy of this regimen in patients who developed resistance or intolerance to conventional antiretroviral therapy (ART). This short report included offenders incarcerated in the Illinois Department of Corrections who were ≥18 years, HIV-infected, had documented antiretroviral resistance, and received EVG/COBI/TDF/FTC + ATV once daily. Based on previous ART, resistance patterns and current medications, seven patients were initiated on once-daily therapy consisting of EVG/COBI/TDF/FTC and ATV. Due to extensive resistance, two of the seven patients were also started on abacavir (ABC) 600 mg daily in addition to EVG/COBI/TDF/FTC and ATV. Of the seven patients, one had ART changed due to concerns of resistance based on a genotype, one experienced a decline in renal function that warranted a change in therapy, and one is currently virologically suppressed on a combination of EVG/COBI/TDF/FTC, ATV, and ABC. The remaining four patients remain virologically suppressed on EVG/COBI/TDF/FTC + ATV. Therapy consisting of EVG/COBI/TDF/FTC and ATV may be a viable option for some treatment-experienced HIV-infected patients. Further studies evaluating the safety, efficacy, and pharmacokinetics of this therapy are warranted, given the lack of information currently available.
我们报告了在有人类免疫缺陷病毒（HIV）感染且有治疗经验的患者中，使用每日一次的elvitegravir 150毫克/考比司他150毫克/替诺福韦酯300毫克/恩曲他滨200毫克（EVG/COBI/TDF/FTC），外加每日一次的阿扎那韦（ATV）300毫克。由于关于这些药物联合使用的可用数据有限，我们的目标是评估和监测该方案在对传统抗逆转录病毒疗法（ART）产生耐药性或不耐受的患者中的安全性和疗效。这份简短报告纳入了伊利诺伊州惩教部年龄≥18岁、感染HIV、有抗逆转录病毒耐药记录且每日接受一次EVG/COBI/TDF/FTC + ATV治疗的罪犯。根据既往ART、耐药模式和当前用药情况，7名患者开始接受每日一次的由EVG/COBI/TDF/FTC和ATV组成的治疗。由于广泛耐药，这7名患者中有2名除了接受EVG/COBI/TDF/FTC和ATV治疗外，还开始每日服用600毫克阿巴卡韦（ABC）。在这7名患者中，1名因基于基因型的耐药担忧而更换了ART，1名肾功能下降需要更换治疗方案，1名目前通过EVG/COBI/TDF/FTC、ATV和ABC联合治疗实现了病毒学抑制。其余4名患者通过EVG/COBI/TDF/FTC + ATV治疗仍保持病毒学抑制。对于一些有治疗经验的HIV感染患者，由EVG/COBI/TDF/FTC和ATV组成的治疗方案可能是一种可行的选择。鉴于目前缺乏相关信息，有必要进一步开展评估该疗法安全性、疗效和药代动力学的研究。
