Virological failure in two patients with HIV-1 RNA viral loads >1,000,000 copies/ml initiated on elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate

• Published in: Antiviral therapy 2016-01, Vol.21 (2), p.175-180
• Main Authors: Adams, Jessica L, Byrne, Dana, Pepe, Rosalie, Gray, Anastasia, Baxter, John D
• Format: Article
• Language: English
• Subjects: Anti-HIV Agents - administration & dosage; Anti-HIV Agents - therapeutic use; Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination - administration & dosage; Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination - therapeutic use; Female; HIV Infections - blood; HIV Infections - drug therapy; HIV Infections - virology; HIV-1 - genetics; Humans; Lentivirus; Male; Middle Aged; Retroviridae; RNA, Viral - blood; Viral Load
• ISSN: 1359-6535; 2040-2058
• DOI: 10.3851/IMP2987

Very high baseline HIV-1 RNA viral loads require potent and robust antiretroviral regimens to achieve virological suppression. The coformulated single tablet regimen of elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate (EVG/COBI/FTC/TDF) is recommended by the US Department of Health and Human Services for the treatment of HIV-1 in treatment-naive adults and adolescents regardless of baseline CD4(+) T-cell count and viral load. We report two cases of HIV-infected, treatment-naive patients, with baseline HIV-1 RNA viral loads >1,000,000 copies/ml who were initiated on the single tablet regimen EVG/COBI/FTC/TDF, but failed to attain viral load suppression and developed resistance to the components of EVG/COBI/FTC/TDF.