Rueda-Naharro A1, Domínguez-Gozalo A1, Ricote-Lobera I2, Ortiz-Martín B2, García-Benayas E1, Torres-Perea R3
1 Licenciado en Farmacia. Facultativo Especialista en Farmacia Hospitalaria. Servicio de Farmacia
2 Licenciado en Farmacia. Facultativo Especialista en Farmacia Hospitalaria
3 Licenciado en Medicina. Facultativo Especialista de Medicina Interna, Enfermedades Infecciosas-VIH.
Servicio de Medicina Interna
Hospital Universitario Severo Ochoa. Leganés. Madrid (España)
Rev. OFIL 2016, 26;4:280-285
Fecha de recepción: 22/02/2016 – Fecha de aceptación: 28/05/2016
Aída Rueda Naharro
C/Gobernador, 2 – 1º C
28912 Leganés (Madrid)
Correo electrónico: firstname.lastname@example.org
Objective: To evaluate efficacy, safety and economic impact of darunavir (DRV) monotherapy 800 mg/day boosted with ritonavir (r) 100 mg/day pre-treated HIV+ patients.
Method: Observational, retrospective study including HIV+ patients on monotherapy with DRV/r. Demographic variables were collected and also others such as pre- and post-TAR DRV/r monotherapy length, adherence and coinfection with hepatitis C virus (HCV), CD4 counts and plasma viral loads. The causes of suspension of monotherapy were discussed. The economic impact is estimated from the difference between the cost of the previous TAR and monotherapy, based on the average acquisition price.
Results: 51 patients were included. 47,1% were coinfected with HCV. The average length of monotherapy was 26 months. The adherence to the treatment was on average about 95,25%. Virologic failure was detected in seven patients. Eleven patients discontinued treatment due to adverse reactions, drug interactions and/or laboratory abnormalities. There were no significant differences between CD4 pre- vs. post- vs. monotherapy. We also found no relation between DRV/r failure and IP pretreatment, adherence, HCV coinfection, previous plasma viral load or between pre- vs. post- laboratory tests.
At the end of the study, 32 patients (62,7%) continued with monotherapy. The average savings per patient treated with DRV/r was 200.8€/month.
Conclusions: DRV/r monotherapy is effective and cost-effective, but does not significantly improve the side effect profile in the short term.
Key Words: Darunavir, ritonavir, monotherapy, HIV, HIV+, antiretroviral treatment.