Clinical Improvement by Switching to an Integrase Strand Transfer Inhibitor in Hemophiliac Patients with HIV: The Japan Cohort Study of HIV Patients Infected through Blood Products



Miyuki Kawado1, *, Shuji Hashimoto1, Shin-ichi Oka2, Katsuyuki Fukutake3, Satoshi Higasa4, Hiroshi Yatsuhashi5, Miwa Ogane2, Manabu Okamoto6, Takuma Shirasaka6
1 Department of Hygiene, Fujita Health University School of Medicine, Toyoake, Japan
2 AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
3 Department of Laboratory Medicine, Tokyo Medical University Hospital, Tokyo, Japan
4 Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
5 Clinical Research Center, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
6 AIDS Medical Center, National Hospital Organization Osaka National Hospital, Osaka, Japan


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© 2017 Kawado et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at Department of Hygiene, Fujita Health University School of Medicine, 1-98 Kutsukake-cho, Toyoake, Aichi 470-1192, Japan; Tel: +81-562-93-2456; Fax: +81-562-93-2456; E-mail: kawado@fujita-hu.ac.jp


Abstract

Objective:

This study aimed to determine improvement in HIV RNA levels and the CD4 cell count by switching to an antiretroviral regimen with an integrase strand transfer inhibitor (INSTI) in patients with HIV.

Method:

This study was conducted on Japanese patients with HIV who were infected by blood products in the 1980s. Data were collected between 2007 and 2014. Data of 564 male hemophiliac patients with HIV from the Japan Cohort Study of HIV Patients Infected through Blood Products were available. Changes in antiretroviral regimen use, HIV RNA levels, and the CD4 cell count between 2007 and 2014 were examined.

Results:

From 2007 to 2014, the proportion of use of a regimen with an INSTI increased from 0.0% to 41.0%. For patients with HIV who used a regimen, including an INSTI, the proportion of HIV RNA levels <50 copies/mL significantly increased from 58.3% in 2007 to 90.6% in 2014. Additionally, the median CD4 cell count significantly increased from 380/μL to 438/μL.

Conclusion:

There is a large effect of switching to an antiretroviral regimen with an INSTI for Japanese patients with HIV who are infected by blood products. This suggests that performing this switch in clinical practice will lead to favorable effects.

Keywords: HIV, AIDS, Antiretroviral therapy, HIV RNA, CD4 cell count, Integrase strand transfer inhibitor.