Simplifying antiviral treatment for people with long-term HIV infection
Sep 5, 2019
Especially in nations with developed health systems, HIV infection is increasingly managed as a chronic medical condition requiring life-long drug therapy. Researchers have recently addressed the possibility that the number of antiretroviral drugs might be able to be reduced for some affected people without compromising viral suppression. The ECOVIR study prospectively study assessed whether patients treated combination anti-retroviral therapy (ART: ≥4 antiretrovirals for ≥24 weeks and virally suppressed for ≥48 weeks), a drug-reduced (DR) regimen could be implemented. The study involved stopping drugs where the virus had less genotypically susceptibility, aiming to attain as regimen with ≤3 antiretrovirals. Of 89 eligible individuals, in 86 cases a reduced-drug regimen was and 71 were switched to a DR regimen. These were people with long-standing infection: mean age 58 (53–65) years, duration of treatment 24 (21–26) years and viral suppression 8 (6–11) years. The cumulative profiles demonstrated resistance to many of the drugs or drug combinations involved. The final DR regimens involved two-drug or three-drug regimen in 54 patients (76%) and in 17 patients (24%), respectively. The success rate of a DR regimen at week 24 was 93.9% (95% CI 84.4–97.6, Kaplan–Meier estimate), but 4 patients experienced virological failure. As well as reduced pill-burden, the new approach achieved substantial financial savings. Read more here
