Combination therapy with a novel agent, albuvirtide, in hospitalised AIDS patients

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INFECTIOUS DISEASE

Last updated: 3 November 2021 | In: AIDS, Infectious Disease, HIV

Article Keywords

treatment-experienced, lopinavir, ritonavir, HIV, dolutegravir, AIDS, albuvirtide

Delayed therapy start and antiretroviral therapy (ART) resistance are two common issues affecting up to 33% and 17% of patients infected with human immunodeficiency virus (HIV), respectively.^1,2 These patients commonly present with higher viral loads, lower CD4 T-cell count, and complications such as infections requiring acute treatment.¹ For those patients presenting with acquired immunodeficiency syndrome (AIDS) or those who have breakthrough HIV, and who present with opportunistic infections and comorbidities requiring hospitalisation, ART treatments are limited.²

Albuvirtide is a novel long-acting HIV fusion inhibitor developed by Frontier Biotechnologies.² Data from a retrospective analysis of hospitalised patients treated with albuvirtide (ABT)-based dual therapy with dolutegravir (DTG) or lopinavir/ritonavir (LPV/r) was presented at the European AIDS Clinical Society 2021 Conference.

A total of 160 patients with severe AIDS critically ill with HIV-associated infection or complication were analysed.² The mean age of patients was 47.4 years, and 79% had ≥2 opportunistic infections at baseline. The majority were ART-naïve (55%), while 45% were ART-experienced.² Of the 160 patients, albuvirtide was used in combination with dolutegravir in 88 treatment-naïve and 69 pre-treated patients, while albuvirtide was used in combination with lopinavir/ritonavir in three pre-treated patients.²

Regardless of treatment history, ABT-dual showed significant decrease of mean HIV-1 RNA levels within two weeks of treatment; mean HIV-1 RNA levels dropped from 5.28 log₁₀ copies/mL at baseline to 2.36 log₁₀ copies/mL after two weeks. After 4 and 8 weeks of treatment, HIV-RNA levels had further decreased to 2.15 log₁₀ copies/mL and 1.97 log₁₀ copies/mL (p<0.01), respectively.² Likewise, ABT-dual showed significant improvement in CD4+ T-cell count. The median CD4+ T-cell counts significantly increased from 47/μL to 79/μL after two weeks, and to 142/μL and 157/μL at 4 and 8 weeks thereafter.² The study authors noted this data provides real-world evidence of the efficacy of ABT-dual therapy, with rapid virological suppression.

A subgroup analysis of treatment-naïve patients reflected similar decreases in HIV-1 RNA level to the whole population, while pre-treated patients maintained the decrease only to two weeks.² Similar increases in CD4+ T-cell counts were observed in both treatment-naïve and pre-treated groups after 4 weeks of ABT-dual.² In pre-treated patients, median CD4+ T-cell count had nearly tripled after 8 weeks of treatment. No treatment-emergent adverse events were identified in the retrospective analysis, nor were injection site reactions observed.²

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References

1. Metsch LR et al. Am J Public Health. 2009;99(6):1045-1049.
2. Pennings PS. Infect Dis Rep. 2013;5(Suppl 1):e5.
3. He, S et al. ePoster PE2/55. Presented at EACS 2021.

Disclaimer

This article is not medical advice. Patients should seek personal assessment by a licenced specialist. Physicians are recommended to read the full publication(s) as cited in the article before making medical decisions. This article does not supersede nor replace the published article(s).