Effectiveness and Risk Factors for Virological Outcome of Raltegravir-Based Therapy for Treatment-Experienced HIV-Infected Patients

Objective We evaluated the effectiveness of a raltegravir (RAL)-containing regimen plus an optimized background regimen in HIV-1 highly treatment-experienced patients. Design A retrospective cohort, multicentre study was conducted. Methods Adult (> 16 years old) HIV treatment-experience patients starting therapy with a RAL-containing regimen were included. Effectiveness was evaluated as the percentage of patients with an undetectable HIV-1 RNA viral load (< 50 and < 200 copies/mL) after 48 weeks, and changes in CD4+ cell counts. We evaluated the risk factors associated with treatment failure. Results Of the 107 patients in the cohort, 86% were men, the median age was 45 years [interquartile range (IQR) 40- 52] and the median number of previous regimens was six (IQR 4-7). After 48 weeks of treatment, 73% ( IQR 63-80%) of patients ( n = 78) had a viral load of \ 50 copies/mL and 85% (IQR 77-90%) ( n = 91) had < 200 copies/mL. In a logistic regression model, risk factors associated with a virological outcome of HIV-1 RNA of < 200 copies/mL were age > 40 years [odds ratio (OR) 5.61; 95% confidence interval (CI) 1.61-18.84; P = 0.006] and use of tenofovir in the regimen ( OR 0.16; 95% CI 0.03-0.80; P = 0.026). Conclusions In this Mexican cohort, RAL achieved high rates of virological suppression and an increase in CD4+ cell count in highly treatment- experienced patients infected with HIV- 1. Age > 40 years was associated with a good virological outcome, contrary to tenofovir use, which was associated with a poor virological outcome.