EACS2023: 674 Durability of two-drug antiretroviral regimens as maintenance therapy in people living with HIV and reasons for switch to a threedrug regimen: a real-life cohort study E. Bontemps , A. Meybeck , A. Diarra , M. Tetart , V. Derdour , M. Degrendel , L. Bocket , E.K. Alidjinou , O. Robineau CH Tourcoing, Tourcoing, France, CHU Lille, Lille, France General data Abstract category: Antiretroviral therapy – observational studies Abstract body Purpose: Use of two-drug regimens (2DR) reduces exposure to antiretroviral drugs while maintaining viral suppression. We aim to assess real-life durability of 2DR in treatment-experienced people living with HIV (PLHIV) virologically suppressed. Method: We conducted a monocentric study in Tourcoing Hospital, a regional referral center for PLHIV. PLHIV who received 2DR as maintenance therapy (viral load<50 copies/ml at initiation) between 1 January 2010 and 1 May 2023 were included. Duration of 2DR, reasons for and factors associated with switching to 3DR were analyzed. Results: A total of 589 PLHIV were included. The median age was 48 years (IQR: 39-56). The median duration on antiretroviral therapy was 8.2 years (IQR 4.5-12.9). Dolutegravir (DTG) or ritonavir-boosted protease inhibitor (PI/r) based 2DR were the most prescribed regimens respectively in 63% and 17% of cases. Sixty-nine patients (11.7%) received cabotegravir-rilpivirine. Reasons for initiating 2DR were mainly drug reduction (n=353, 59.9%) or side effects (n=81, 13.8%). Median follow-up time on 2DR was 21 months (IQR 8-38). One hundred fifteen patients (19.5%) switched to 3DR after a median duration of 10 months (IQR 3-19). Twenty-six patients (22.6%) had a detectable viral load when switching to 3DR. Main reasons for switching to 3DR were side effects (n=34, 29.6%), drug reduction (n=28, 24.3%), treatment reinforcement (n=20, 17.4%). Low nadir of CD4 count (224/mm3 (IQR 132-332) vs 289/mm (IQR 178-424), p<0.001), history of multiple drug regimens (3 (IQR 2-6) vs 3 (IQR 2-5), p=0,006), and HBV co-infection (3.5% vs 0.4%, p=0.016) were associated with switching to 3DR. 2DR initiation for drug reduction was associated with its maintenance (12,8% vs 29,7%, p<0,0001). 2DR durability was longer with DTG-based regimen (p<0.0001) (Fig. 1). Conclusions: Switching from 2DR to 3DR was common. Drug reduction and side effects were the main reasons for switching. Use of newly recommended 2DR could improve 2DR durability in the future. General conditions 1. I confirm that I previewed this abstract and that all information is correct. I accept that the content of this abstract cannot be modified or corrected after the submission deadline and I am aware that it will be published exactly as submitted.: Yes 2. I confirm that the submission of the abstract constitutes my consent to publication (e.g. conference website, programmes, other promotions, etc.). : Yes 3. I herewith confirm that the contact details saved in this system are those of the corresponding author, who will be notified about the status of the abstract. The corresponding author is responsible for informing the other authors about the status of the abstract.: Yes 4. I agree that all data provided may be used (saved, stored, processed, transmitted and deleted) in compliance with the privacy policy to provide the services described.: Yes 1 1 1 1 1 1 2 2 1 1 2 3 146 19TH EUROPEAN AIDS CONFERENCE | WARSAW 2023
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