Bictegravir/emtricitabine/tenofovir alafenamide in paediatrics: Real-life experience from a French cohort (2019-2023).

Autor: Frange P; Laboratoire de Microbiologie Clinique, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.; EHU 7328 PACT, Institut Imagine, Université Paris Cité, Paris, France.; Unité d'Immunologie, Hématologie et Rhumatologie Pédiatriques, Hôpital Necker-Enfants Malades, AP-HP, Paris, France., Veber F; Unité d'Immunologie, Hématologie et Rhumatologie Pédiatriques, Hôpital Necker-Enfants Malades, AP-HP, Paris, France., Burgard M; Laboratoire de Microbiologie Clinique, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France., Blanche S; Unité d'Immunologie, Hématologie et Rhumatologie Pédiatriques, Hôpital Necker-Enfants Malades, AP-HP, Paris, France.; Université Paris Cité, Paris, France., Avettand-Fenoel V; Université Paris Cité, Paris, France.; INSERM, U1016, CNRS, UMR8104, Institut Cochin, Paris, France.; Laboratoire de Virologie, Hôpital Cochin, AP-HP, Paris, France.
Jazyk: angličtina
Zdroj: HIV medicine [HIV Med] 2024 Feb; Vol. 25 (2), pp. 299-305. Date of Electronic Publication: 2023 Oct 08.
DOI: 10.1111/hiv.13562
Abstrakt: Objectives: Although widely recommended, data on bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) efficacy in HIV-1-infected children/adolescents are mainly extrapolated from studies in adults and one paediatric trial in which subjects have good treatment adherence. This study aimed to provide data about the risk of virological failure (VF) and acquired genotypic resistance in children and adolescents receiving BIC/FTC/TAF in a real-world setting.
Methods: This retrospective monocentric study included 74 paediatric patients who received BIC/FTC/TAF during ≥6 months in 2019-2023. VF was defined as not achieving a plasma viral load <50 copies/mL within 6 months of BIC/FTC/TAF initiation or as experiencing virological rebound ≥50 copies/mL.
Results: Most patients were antiretroviral therapy (ART)-experienced (93.2%), previously exposed to integrase inhibitors (85.1%) and displayed viral suppression at baseline (67.6%). Their median age was 11.2 years [interquartile range (IQR): 8.8-15.2]. BIC/FTC/TAF introduction reduced treatment burden in most ART-experienced subjects. Genotypic susceptibility score of BIC/FTC/TAF was ≥2 in all cases. Median follow-up was 40 months (IQR: 21-46). VF occurred in 28 people (37.8%), more frequently in the case of VF versus viral suppression at baseline (68% vs. 26%, P = 0.02). BIC/FTC/TAF was interrupted for suspected intolerance in only one case (1.4%). Nucleoside reverse transcriptase inhibitor (NRTI) mutation (T69D/N) emerged in one patient (3.6% of VF) after 47 months of continuous detectable viraemia while on ART. No acquisition of mutations in the integrase gene was observed.
Conclusion: Because of its high genetic barrier to resistance, BIC/FTC/TAF could be especially useful in the paediatric population, in which the risk of poor treatment adherence and VF is high.
(© 2023 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.)
Databáze: MEDLINE
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