Virological Failure in Two Patients with HIV-1 RNA Viral Loads >1,000,000 copies/ml Initiated on Elvitegravir/Cobicistat/Emtricitabine/Tenofovir Disoproxil Fumarate
Jessica Adams, Dana D. Byrne, Rosalie Pepe, Anastasia Gray, John D. Baxter
Abstract
Jessica Adams, Dana D. Byrne, Rosalie Pepe, Anastasia Gray, John D. Baxter
Abstract
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.
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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.
Key concepts: Elvitegravir, Cobicistat, Emtricitabine, Viral load, Medicine, Regimen, Virology, Human immunodeficiency virus (HIV)