4CPS-156 Analysis of antiretroviral therapy switch in 2022 in people living with human inmunodeficiency virus: reasons and immunovirological efficacy

<h3>Background and Importance</h3> In the past, people living with human inmunodeficiency virus (PLWHIV) had a fatal outcome due to the complications that resulted from the disease. Nowadays, thanks to the wide therapeutic arsenal available, life expectancy is almost close to general population. However, it is common for treatment changes to be made during follow-up in order to optimise and individualise it. <h3>Aim and Objectives</h3> Characterise the reasons for switching antiretroviral therapy (ART) in PLWHIV in a tertiary level hospital during 2022. Secondly, evaluate the efficacy and safety of the new treatment. <h3>Material and Methods</h3> Observational, retrospective, descriptive study of patients who underwent change of their ART during 2022. Epidemiological, clinical and immunovirological variables were collected from the electronic prescription programme. This study is part of Master Esther’s Master Final Project 2023/2024. <h3>Results</h3> 84 patients were included, 88,1% were men. The main reason for changing ART was to simplify it (25%), consequently, dual therapy increased 15,5% and triple therapy decreased 14,6%. The second reason was occurrence of adverse events (22,6%). The most prevalent ones were central nervous system symptoms (8,3%), insomnia (3,6%) or hypertriglyceridaemia/hypercholesterolaemia (3,6%). Thirdly, due to a virologic failure (15,48%). The use of non-nucleoside reverse transcriptase inhibitors (NNRTIs) decreased from 27,4% to 15,5%; in contrast, proportion of integrase inhibitors (INIs) are the same, although use of 2° generation INIs increases from 91% to 100%. In terms of efficacy, the proportion of patients with undetectable plasmatic viral load (PVL) increased to 91,7% from 83,3% after the change. There is no differences in terms of safety. <h3>Conclusion and Relevance</h3> The most common reason for changing ART is to simplify it for patient’s comfort, because it is difficult to achieve greater efficacy and safety than oral drugs avaliables. In fact, the new lines of research are focused on other formulations like long-acting, instead of improving security o efficacy. Also, ART tends to be based more on 2° generation INIs in due to their better security profile and fewer interactions, at the expense of NNRTIs that are not recommended as first-line in clinical guidelines. Finally, the efficacy of new ART was demonstrated by the increase in the proportion of patients with undetectable PVL. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest