Durability of Integrase STrand Inhibitor (InSTI)-based regimen in geriatric people living with HIV in the GEPPO cohort.
<h4>Objective</h4>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.<h4>Design</h4>This is an analysis conducted on the Geriatric Patients Livin...
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2021
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oai:doaj.org-article:cf2c013763544ceeaba0c66b5fab75cb2021-12-02T20:19:17ZDurability of Integrase STrand Inhibitor (InSTI)-based regimen in geriatric people living with HIV in the GEPPO cohort.1932-620310.1371/journal.pone.0258533https://doaj.org/article/cf2c013763544ceeaba0c66b5fab75cb2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0258533https://doaj.org/toc/1932-6203<h4>Objective</h4>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.<h4>Design</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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.Emanuele FocàAndrea CalcagnoStefano CalzaStefano RenzettiAnnacarla ChiesaMatteo SianoGiuseppe De SocioStefania PiconiGiancarlo OrofinoGiordano MadedduAnna Maria CattelanSilvia NozzaMicol FerraraJovana MilicBenedetto Maurizio CelesiaFrancesco CastelliGiovanni GuaraldiPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10, p e0258533 (2021) |
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| spellingShingle |
Medicine R Science Q Emanuele Focà Andrea Calcagno Stefano Calza Stefano Renzetti Annacarla Chiesa Matteo Siano Giuseppe De Socio Stefania Piconi Giancarlo Orofino Giordano Madeddu Anna Maria Cattelan Silvia Nozza Micol Ferrara Jovana Milic Benedetto Maurizio Celesia Francesco Castelli Giovanni Guaraldi Durability of Integrase STrand Inhibitor (InSTI)-based regimen in geriatric people living with HIV in the GEPPO cohort. |
| description |
<h4>Objective</h4>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.<h4>Design</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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. |
| format |
article |
| author |
Emanuele Focà Andrea Calcagno Stefano Calza Stefano Renzetti Annacarla Chiesa Matteo Siano Giuseppe De Socio Stefania Piconi Giancarlo Orofino Giordano Madeddu Anna Maria Cattelan Silvia Nozza Micol Ferrara Jovana Milic Benedetto Maurizio Celesia Francesco Castelli Giovanni Guaraldi |
| author_facet |
Emanuele Focà Andrea Calcagno Stefano Calza Stefano Renzetti Annacarla Chiesa Matteo Siano Giuseppe De Socio Stefania Piconi Giancarlo Orofino Giordano Madeddu Anna Maria Cattelan Silvia Nozza Micol Ferrara Jovana Milic Benedetto Maurizio Celesia Francesco Castelli Giovanni Guaraldi |
| author_sort |
Emanuele Focà |
| title |
Durability of Integrase STrand Inhibitor (InSTI)-based regimen in geriatric people living with HIV in the GEPPO cohort. |
| title_short |
Durability of Integrase STrand Inhibitor (InSTI)-based regimen in geriatric people living with HIV in the GEPPO cohort. |
| title_full |
Durability of Integrase STrand Inhibitor (InSTI)-based regimen in geriatric people living with HIV in the GEPPO cohort. |
| title_fullStr |
Durability of Integrase STrand Inhibitor (InSTI)-based regimen in geriatric people living with HIV in the GEPPO cohort. |
| title_full_unstemmed |
Durability of Integrase STrand Inhibitor (InSTI)-based regimen in geriatric people living with HIV in the GEPPO cohort. |
| title_sort |
durability of integrase strand inhibitor (insti)-based regimen in geriatric people living with hiv in the geppo cohort. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2021 |
| url |
https://doaj.org/article/cf2c013763544ceeaba0c66b5fab75cb |
| work_keys_str_mv |
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