Resumen: Background: HIV-2 is a neglected virus despite estimates of 1–2 million people being infected worldwide. The virus is naturally resistant to some antiretrovirals used to treat HIV-1 and therapeutic options are limited for patients with HIV-2.
Methods: In this retrospective observational study, we analysed all HIV-2-infected individuals treated with inte- grase strand transfer inhibitors (INSTIs) recorded in the Spanish HIV-2 cohort. Demographics, treatment modal- ities, laboratory values, quantitative HIV-2 RNA and CD4 counts as well as drug resistance were analysed.
Results: From a total of 354 HIV-2-infected patients recruited by the Spanish HIV-2 cohort as of December 2017, INSTIs had been given to 44, in 18 as first-line therapy and in 26 after failing other antiretroviral regimens. After a median follow-up of 13 months of INSTI-based therapy, undetectable viraemia for HIV-2 was achieved in 89% of treatment-naive and in 65.4% of treatment-experienced patients. In parallel, CD4 gains were 82 and 126cells/mm3, respectively. Treatment failure occurred in 15 patients, 2 being treatment-naive and 13 treatment-experienced. INSTI resistance changes were recognized in 12 patients: N155H (5), Q148H/R (3), Y143C/G (3) and R263K (1).
Conclusions: Combinations based on INSTIs are effective and safe treatment options for HIV-2-infected individ- uals. However, resistance mutations to INSTIs are selected frequently in failing patients, reducing the already limited treatment options. Idioma: Inglés DOI: 10.1093/jac/dkz007 Año: 2019 Publicado en: The Journal of antimicrobial chemotherapy 74, 5 (2019), 1357-1372 ISSN: 1460-2091 Factor impacto JCR: 5.439 (2019) Categ. JCR: INFECTIOUS DISEASES rank: 10 / 93 = 0.108 (2019) - Q1 - T1 Categ. JCR: PHARMACOLOGY & PHARMACY rank: 22 / 270 = 0.081 (2019) - Q1 - T1 Categ. JCR: MICROBIOLOGY rank: 24 / 134 = 0.179 (2019) - Q1 - T1 Factor impacto SCIMAGO: 2.23 - Infectious Diseases (Q1) - Pharmacology (medical) (Q1) - Pharmacology (Q1) - Microbiology (medical) (Q1)