inPractice® - Modifying NNRTI-Based Regimens

Modifying Antiretroviral Therapy in Virologically Suppressed HIV-Infected Patients

Author: José R. Arribas, MD (More Info)
Section Editor: Eric S. Daar, MD
Editors in Chief: Joseph J. Eron, Jr., MD; Daniel R. Kuritzkes, MD
Last Reviewed: 10/18/21 (What's New)

Summary

Studies examining the efficacy of switching NNRTIs in virologically suppressed patients because of toxicity found a majority of patients safely maintained virologic suppression^{[Gulick 2006; Schouten 2010; Parienti 2007]}
Switch to emtricitabine/rilpivirine/tenofovir AF from emtricitabine/rilpivirine/tenofovir DF or efavirenz/emtricitabine/tenofovir DF noninferior with improvements in bone and renal safety^{[Orkin 2017]}

Switching from Other NNRTIs to Doravirine

A total of 24% of participants in the DRIVE-SHIFT trial,^{[Johnson 2019]} which evaluated a switch to doravirine/lamivudine/tenofovir DF in virologically suppressed patients on stable ART for ≥ 6 months with no previous virologic failure or resistance to doravirine if they were on NNRTI-based regimens before the switch

Switching From an NNRTI-Based to an INSTI-Based Regimen

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Keywords: Adherence, Cardiovascular Disease, Dyslipidemia, Fat Perturbations, Switch Strategies, Treatment Complications