Infectious Diseases
Journal Scan

Integrase Inhibitor-Based Regimen Shows Promise in Treating HIV-2

Posted on

An integrase inhibitor-based regimen to treat human immunodeficiency virus-2 (HIV-2) has shown good safety, efficacy, and tolerability in a small clinical trial conducted in Senegal, West Africa. HIV-2 is rare, particularly in areas outside of West Africa. In the United States, only 166 cases of HIV-2 were documented between 1988 and 2010. Subsequently, HIV-2 has received relatively little attention, with infected individuals often having suboptimal outcomes despite HIV-2 generally having a less aggressive disease course with slower deterioration of immune function.

The 48-week open-label study included 30 HIV-2-positive, antiretroviral-therapy naïve individuals with World Health Organization stage 3 or 4 disease or CD4 counts <750 cells/mm3.  Of these individuals, 29 completed the study, during which they were treated with a single-tablet regimen containing elvitegravir-cobicistat-emtricitabine-tenofovir disoproxil fumarate (E/C/F/TDF; Stribild®).

Efficacy findings were as follows at week 48:

  • No deaths and no new AIDS-associated clinical events.
  • Increase in median baseline CD4 count of 408 cells/mm3 (range, 34-747/mm3) by a median +161 cells/mm3 (range, 27-547/mm3) at week 48.
  • 25 patients had baseline HIV-2 viral loads <50 copies/mL of plasma.
  • Patients with detectable HIV-2 viral loads had a median of 41 copies/mL of plasma (range, 10-6135 copies/mL).
  • Using a mITT analysis (FDA Snapshot method), 28 of 30 (93.3%; 95% confidence interval, 77.9%-99.2%) had viral suppression at 48 weeks.
  • 1 patient had virologic failure; patient was found to have multidrug resistant HIV-2 (reverse transcriptase mutation: K65R; integrase mutations: G140S and Q148R).

There were 8 grade 3-4 adverse events but none were deemed study related. Patient adherence and acceptability were good.

Read more here.


Ba S, Raugi DN, Smith RA, et al; University of Washington–Dakar HIV-2 Study Group. A trial of a single tablet regimen of elvitegravir, cobicistat, emtricitabine, and tenofovir disoproxil fumarate for the initial treatment of HIV-2 infection in a resource-limited setting: 48 week results from Senegal, West Africa. Clin Infect Dis. 2018 Apr 17. doi: 10.1093/cid/ciy324.

Related Articles
FDA Approves New Antibacterial Drug for Serious Lung Disease Under Novel Pathway
Mar 16, 2020
No Benefit Associated with Tetanus, Diphtheria Booster in Adults
Mar 05, 2020
NORD Video: Congenital CMV
Mar 01, 2020