4CPS-062 Patients with darunavir/cobicistat/emtricitabine/tenofovir alafenamide treatment in a third level hospital

Background and importanceDarunavir/cobicitat/emtricitabine/tenofovir alafenamide (DRV/c/FTC/TAF) is a new single tablet regimen for HIV. Another advantage is its coformulation with tenofovir alafenamide, and a better safety profile.Aim and objectivesTo evaluate reasons for switching from one antiretroviral therapy (ART) to DRV/c/FTC/TAF, and to evaluate effectiveness, safety and patient satisfaction.Material and methodsThis was an observational, descriptive, retrospective study of patients who started treatment with DRV/c/FTC/TAF and had an analytical control after the start of treatment. Variables collected: demographic, pharmacotherapeutic (reason for change to DRV/c/FTC/TAF, previous ART, number of previous active ingredients and tablets) and clinical (CD4 and CD8 lymphocytes, CD4/CD8 quotient, viral load and glomerular filtrate prior to and a median of 105 days after starting treatment). Satisfaction with ART was measured at 5 months using the ESTAR questionnaire (developed in Spanish based on the English language version of the HIV treatment satisfaction questionnaire (HIVTSQ)), with scores ranging from 0 to 60 points.ResultsThere were 38 patients (median age 50.5 years; 66.7% women) who initiated DRV/c/FTC/TAF. Three patients were not included: two naive and one who discontinued after a month due to intolerance. The previous ART was protease inhibitor/potentiator (PI/p) with two nucleotide analogue reverse transcriptase inhibitors (2NRTI) in 54.3% of patients, PI/p in 11.4%, integrase inhibitor (INSTI) with NRTI in 11.4% and 22.9% other. Patients switched from tenofovir diproxyl fumarate (TDF) to TAF (45.7%). Patients changed from an average of 2.57 active principles daily to 3, and from 1.78 tablets to 1.Reasons for change were renal in 40%, CD4 decrease I 8.6%, renal and bone in 8.6%, simplification and lack of adherence in 8.6% and other in 34.2%. Median CD4 changed from 505 to 684; median CD8 from 692 to 764; and median CD4/CD8 from 0.66 to 0.69. Undetectable viral load remained stable in 97.7% of patients and glomerular filtrate in 94.3%. Scores in the ESTAR questionnaire were higher than 50 in 80% of patients.Conclusion and relevanceIn daily practice, DRV/c/FTC/TAF was used in most cases to prevent damage to renal function. DRV/c/FTC/TAF is an effective and safe treatment which maintains viral load and glomerular filtrate. Patient satisfaction with the treatment was excellent.References and/or acknowledgementsNo conflict of interest.