Among African American patients with HIV infection, virologic suppression was maintained during treatment with bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF), regardless of pre-existing resistance, viral blips, or suboptimal adherence, according to research presented at the IDWeek, held virtually from September 29 to October 3, 2021.

Researchers used data obtained from a phase 3 multicenter study to assess resistance, viral blips, adherence, and virologic outcomes at week 72 among patients treated with B/F/TAF. Patients with resistance to either non-nucleotide reverse transcriptase inhibitors (NNRTI), protease inhibitors (PI), or certain NRTIs were included in the study. In addition, patients with M184V/I mutations and those with 3 or more thymidine analog mutations also met the inclusion criteria. Historical genotypes and retrospective baseline proviral DNA genotyping determined pre-existing resistance, and pill counts were used to calculate adherence rates. Viral blips were defined as transient HIV-1 RNA viral loads that were greater than or equal to 50 copies/mL.

Among a total of 489 patients included in the study, all had switched to treatment with B/F/TAF and had 1 or more post-switch HIV-1 RNA viral load measurement(s) available at the time of enrollment. Of patients included in the study, baseline genotypic data were available for 96% (n=468) of those with protease/reverse transcriptase mutations and 93% (n=453) of those with integrase-type mutations.


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Of 468 patients with protease/reverse transcriptase mutations, 68 (15%) had pre-existing resistance to NRTIs, 50 (11%) had resistance to M184V/I mutations, 36 (8%) had 1 or more thymidine analog mutations, 101 (22%) had NNRTI resistance, and 61 (13%) had PI resistance.

At week 72, HIV viral loads greater than 50 copies/mL were measured in 99% of patients at their last study visit. In regard to viral blips, the mean frequency was 1% per timepoint and no association was found between viral blips and occurrence of virologic failure. Medication adherence rates were less than 95% in 112 patients, of whom 110 had less than 50 copies/mL on measurement of HIV viral load at their last study visit. Of note, the researchers found that all patients with medication adherence rates of less than 80% (n=14) also had viral load measurements of less than 50 copies/mL. In addition, none of the included patients developed treatment emergent resistance to B/F/TAF or discontinued the medication regimen due to lack of efficacy.

“Continued HIV [virologic] suppression and absence of treatment-emergent resistance demonstrate the efficacy of B/F/TAF in African Americans regardless of adherence or pre-existing resistance to NNRTIs, PIs, or non-tenofovir NRTIs,” the researchers concluded.

Disclosure: Some author(s) declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

Andreatta K, D’Antoni ML, Chang S, et al. High efficacy of bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) in african american adults with HIV including those with preexisting resistance, viral blips, and suboptimal adherence. Presented at: IDWeek; September 29 to October 3, 2021. Poster 629.

This article originally appeared on Infectious Disease Advisor