Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy.
Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy.
PLoS One. 2021 Oct 13;16(10):e0258533. doi: 10.1371/journal.pone.0258533. eCollection 2021.
To investigate the durability of the first integrase inhibitor-based regimen in a HIV geriatric multicentric prospective cohort and to explore the reasons of regimen discontinuation.
This is an analysis conducted on the Geriatric Patients Living with HIV/AIDS (GEPPO) cohort, an Italian prospective observational multicentre cohort of people living with HIV with 65 years of age or more.
The analysis was performed using R (version 4.0.2). The tests performed were two sided assuming a 5% significance level (Kruskal-Wallis test, Chi-squared test, log-rank test and a Cox Proportional Hazard model). The proportion of participants discontinuing the three regimens was displayed using cumulative curves.
Among 1531 patients enrolled between 2017 and 2019 in the GEPPO cohort, we included 822 participants in this analysis. At baseline, median age was 69.8, the immunovirological profile good, multimorbidity was present in 42.3% of participants, while 27.4% were on polypharmacy. Overall, 483, 243 and 96 participants received DTG, RAL and EVG/c respectively as first InSTI. At the end of the follow up 6.4%, 21.1% and 22.9% participants discontinued DTG, RAL and EVG/c respectively. Using a log-rank test, EVG showed a significantly lower durability than DTG (p<0.001) or RAL (p 0.05) or both, DTG and RAL (p<0.001). Among participants who discontinued their regimen we found 0 virological failure and 56.7% simplification/deprescription.
The three integrase inhibitors considered showed a good durability and no virological failures in geriatric patients such as those enrolled in the GEPPO cohort when used in a two or three drug regimen.
在一项 HIV 老年患者多中心前瞻性队列中研究第一代整合酶抑制剂方案的持久性，并探讨方案中断的原因。
这是对老年 HIV/AIDS 患者生活（GEPPO）队列进行的一项分析，这是一个意大利前瞻性观察性多中心队列，纳入了 65 岁及以上的 HIV 感染者。
使用 R（版本 4.0.2）进行分析。使用双侧检验，假设显著性水平为 5%（Kruskal-Wallis 检验、卡方检验、对数秩检验和 Cox 比例风险模型）进行检验。使用累积曲线显示三种方案中断的参与者比例。
在 2017 年至 2019 年期间纳入的 1531 名 GEPPO 队列患者中，我们纳入了 822 名参与者进行这项分析。基线时，中位年龄为 69.8 岁，免疫病毒学特征良好，42.3%的参与者患有多种合并症，27.4%的患者同时服用多种药物。总体而言，483、243 和 96 名参与者分别接受了 DTG、RAL 和 EVG/c 作为第一代整合酶抑制剂。在随访结束时，分别有 6.4%、21.1%和 22.9%的参与者停止使用 DTG、RAL 和 EVG/c。使用对数秩检验，EVG 的持久性明显低于 DTG（p<0.001）或 RAL（p<0.001）或两者（p<0.001）。在停止治疗的参与者中，我们发现无病毒学失败，56.7%简化/减药。
在 GEPPO 队列中纳入的老年患者中，当将三种整合酶抑制剂联合使用两种或三种药物方案时，三种整合酶抑制剂均显示出良好的持久性，且无病毒学失败。
