Promising clinical trial results for a number of antiretroviral treatments, and further evidence for anal dysplasia screening, were presented at the 53rd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) in Denver, USA, last week.
Trials highlight effective drugs with fewer side effects
Stribild
The results from two phase 3 trials indicate that Stribild, the single daily pill that combines elvitegravir, cobicistat, tenofovir, and emtricitabine, is as effective in controlling HIV in the over 50s as it is in younger adults.
People over 50 gained fewer CD cells on treatment, however this was not thought to be a significant difference. The rate of serious adverse events did not differ greatly between the two age groups. These are important results that contribute to knowledge of best treatment options for an ageing global population of people with HIV.
Stribild and Comparison Combinations Have Similar Efficacy in Over-50s and Under-50s National AIDS treatment Advocacy Project (NATAP) report
Raltegravir Top PIs and NNRTIs in Retrospective Look at Cancer Patients NATAP report
Tenofovir
Another study found that substituting Tenofovir alafenamide (TAF) for tenofovir disoproxil fumarate (TDF) in Stribild is just as effective as TDF, with fewer adverse effects on kidney function and bone density. This is because the TAF formulation is more concentrated in HIV-infected cells, but levels on the blood are much lower than is the case for TDF.
Tenofovir is used in several combination pills including Truvada, (approved in the US for pre-exposure prophylaxis (PrEP)), so if TAF is approved for use it will be a welcome improvement to these combinations. Phase 3 trials are underway.
New tenofovir formulation works equally well with less effect on kidneys and bones AIDSmap report
