Virologic Failure on Rilpivirine May Lead to Broad NNRTI Resistance

In the ECHO and THRIVE trials, 10% of the patients who received rilpivirine-based regimens experienced treatment failure. Nearly half of these patients developed resistance to multiple nonnucleoside reverse transcriptase inhibitors.

As enthusiasm for “one-pill-once-daily” antiretroviral regimens grows, it is becoming increasingly important to distinguish between the available options — currently, tenofovir/FTC/efavirenz (Atripla) and tenofovir/FTC/rilpivirine (Complera). One factor to consider is the resistance consequences of treatment failure with these regimens, as was recently characterized in the ECHO and THRIVE trials.

In these two trials, treatment-naive, HIV-infected patients were randomized to receive rilpivirine or efavirenz, each in combination with two nucleoside reverse transcriptase inhibitors (NRTIs), predominantly tenofovir and FTC. Rates of treatment response were comparable overall, but the reasons for failure differed substantially between the groups:…

Reviewing Author

Charles B. Hicks, MD

Disclosures

Consultant / Advisory boardGilead Sciences; ViiV; Merck

RoyaltiesUpToDate, Inc.

Grant / Research supportNIH; Department of Health and Human Services

Charles B. Hicks, MD

Disclosures

Consultant / Advisory boardGilead Sciences; ViiV; Merck

RoyaltiesUpToDate, Inc.

Grant / Research supportNIH; Department of Health and Human Services

Virologic Failure on Rilpivirine May Lead to Broad NNRTI Resistance

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Reviewing Author