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Effective management of multidrug-resistant HIV with lenacapavir and fostemsavir: A case study.
Int J STD AIDS
November 2024
Serviço de Doenças Infeciosas, Unidade Local de Saúde Gaia/Espinho, Vila Nova de Gaia, Portugal.
Resistance to antiretroviral therapy is an increasing challenge in the management of HIV. We present the case of a woman living with HIV, with a history of multiple treatment regimens and resistances to antiretrovirals, who has been successfully treated with a combination of lenacapavir and fostemsavir for the past year, obtaining an undetectable viral load within one month of starting therapy and reporting no serious side effects. This case is amongst the first to document the combined use of lenacapivir and fostemsavir in treating multidrug-resistant HIV.
View Article and Find Full Text PDFArticle Synopsis
- - The study aimed to examine the occurrence of drug resistance mutations related to integrase strand transfer inhibitors (INSTI-DRMs) in children and adolescents with perinatally acquired HIV who were referred to a perinatal virtual clinic.
- - Among 114 cases reviewed from October 2018 to January 2024, 90% had available resistance sequences, with significant findings showing that many had prior ART exposure and a notable percentage of those developed INSTI-DRMs, primarily from low/middle-income countries.
- - The research recommended treatment adjustments, emphasizing the need for enhanced access to effective therapies and the importance of addressing drug resistance in this patient population, particularly those with extensive treatment histories.
Immunological and virological response to fostemsavir in routine US clinical care: An OPERA cohort study.
HIV Med
January 2025
Epividian, Raleigh, North Carolina, USA.
Article Synopsis
- Fostemsavir is a new drug used alongside other treatments for adults with multidrug-resistant HIV-1, focusing on its real-world effects in the OPERA cohort.
- The study analyzed immunological (CD4 T-cell counts) and virological (viral load) responses in participants starting fostemsavir, categorizing results based on their initial viral load and CD4 count.
- Results showed that while most individuals with suppressed viral loads maintained their status, those with low CD4 counts had notable improvements in immune response with fostemsavir, despite limited virological success in those who were viraemic.
A Narrative Review of Novel Agents for Managing Heavily Treatment-Experienced People Living With HIV.
J Pharm Technol
August 2024
Department of Pharmacy Practice, College of Pharmacy and Pharmaceutical Sciences, The University of Toledo, Toledo, OH, USA.
The objective of this review is to compare ibalizumab, fostemsavir, and lenacapavir, present the clinical trials evaluating each agent, and provide guidance on their use in highly-treatment experienced (HTE) population living with HIV (PWH). A search of PubMed and clinicaltrials.gov was conducted using the search terms: ibalizumab, fostemsavir, and lenacapavir.
View Article and Find Full Text PDFConsensus recommendations for the use of novel antiretrovirals in persons with HIV who are heavily treatment-experienced and/or have multidrug-resistant HIV-1: Endorsed by the American Academy of HIV Medicine, American College of Clinical Pharmacy: An executive summary.
Pharmacotherapy
May 2024
Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Article Synopsis
- There are limited treatment options for people with HIV-1 who have already tried many medicines and have drug-resistant HIV-1.
- Since 2018, three new medications have been approved to help these patients: ibalizumab, fostemsavir, and lenacapavir.
- Experts created guidelines to help doctors use these new medicines better and suggested more areas to study for future research.
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